[Acute cholestatic hepatitis induced by amoxycillin-clavulanic acid combination]

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