ABSTRACT
Adverse reactions to antibiotics constitute a real public health problem. In this work, the frequency, types, predisposing factors and severity of adverse reactions to antibiotics have been analysed. Our retrospective study gathers all adverse reactions to antibiotics produced by spontaneous reporting to the regional pharmacovigilance center in Sfax in the south of Tunisia, for a period of three years. Among 249 cases of drug adverse effects, 82 [32.93%] were related to antibiotics. The age ranged from 5 to 86 years. There were 55 women and 27 men. Seventy [85.36%] adverse reactions to antibiotics among 82 were immune-allergic. In 60 cases [73.17%] patients had medical history of atopy, drug allergy, autoimmunie diseases or chronic conditions requiring poly-medication. 54 patients [65.85%] were taking 3 or more medications. Severe forms have been observed in 12 patients among 82 [14.63%]. Poly-therapy, chronic illness and advanced age are factors favouring the occurrence of adverse reactions to antibiotics. Our results have highlighted the increased risk in patients with a history of allergy to an antibiotic to develop an allergy to another antibiotic
ABSTRACT
Cholestatic hepatitis associated with amoxicillin-clavulanic acid is probably underestimated. The time interval between stopping treatment and the first manifestations may hinder diagnosis. We report a case of cholestatic hepatitis induced by the association amoxicillin-calvulanic acid. A 15-year-old man without significant past medical history received a six-day-course of amoxicillin-calvulanic acid for acute bronchitis. Nine days after completing his treatment, he developed a jaunadice with fever. The biological tests showed conjugated bilirubin of 23 mg/dl without hepatic cytolysis. Extrahepatic obstruction and viral causes were excluded. The clinical symptoms resolved within ten days. The mechanism of amoxicillin-clavulanic- acid- induced hepatitis is probably immunoallergic. Clavulanic acid component of the combination is most likely the cause of hepatitis. Symptoms may appear even a few weeks after stopping the drug. So practitioners should think about this risk, if such symptoms appear even after stopping the drug