학술논문

The predictors of complications in patients with drug-induced liver injury caused by antimicrobial agents.
Document Type
Article
Source
Alimentary Pharmacology & Therapeutics. Jun2010, Vol. 31 Issue 11, p1200-1207. 8p. 1 Diagram, 7 Charts.
Subject
*LIVER injuries
*PATIENTS
*ANTI-infective agents
*LENTIVIRUS diseases
*MYCOBACTERIAL diseases
Language
ISSN
0269-2813
Abstract
Aliment Pharmacol Ther 31, 1200–1207 Background Antimicrobials are the leading cause of idiosyncratic drug-induced liver injury in most series. Aim To determine the incidence and the predictors of complications in patients with drug-induced liver injury caused by antimicrobial agents requiring hospitalization. Methods Medical records of patients with drug-induced liver injury caused by antimicrobial agents were identified by ICD-10, for the period between 2002 and 2006. Clinical information and blood tests during hospitalization were recorded. The causality assessment of drug-induced liver injury was determined by the Roussel UCLAF causality assessment method (RUCAM) scale. Results Of 47 594 in-patient admissions per year, the annual incidence of drug-induced liver injury was 0.03%. Male: female ratio was 7:3 with a median age of 47 years. Eighty reactions of drug-induced liver injury were caused by anti-tuberculosis drugs (85%) and by antibiotics (15%). The median (IQR) of RUCAM scale was 6 (5–8). A total of 36% had HIV infection and 9% of patients had diabetes mellitus. Median (IQR) duration of hospitalization was 9 (5–15) days. Serious complications and death were found in 27.5% and 26%, respectively. By a multivariable logistic analysis, the presence of jaundice was found to be significantly associated with an unfavourable outcome. Conclusion Although rare, antimicrobial agents-related drug-induced liver injury requiring hospitalization has a high mortality rate. The presence of jaundice predicts poor outcome. [ABSTRACT FROM AUTHOR]