OT...Antibiotics and liver damage | Arthritis Information

 

 Antibiotics are the single largest class of agents that cause idiosyncratic drug-induced liver injury (DILI), reports a new study in Gastroenterology, an official journal of the American Gastroenterological Association (AGA) Institute. DILI is the most common cause of death from acute liver failure and accounts for approximately 13 percent of cases of acute liver failure in the U.S.

In this prospective, ongoing, multi-center observational study — the largest of its kind — patients with suspected DILI were enrolled based upon predefined criteria and followed for at least six months. Those with acetaminophen liver injury were excluded.

Researchers found that DILI was caused by a single prescription medication in 73 percent of the cases, by dietary supplements in 9 percent and by multiple agents in 18 percent. More than 100 different agents were associated with DILI; antimicrobials (45.5 percent) and central nervous system agents (15 percent) were the most common. Of the dietary supplements causing DILI, compounds that claim to promote weight loss and muscle building accounted for nearly 60 percent of the cases. The study found that at least 20 percent of patients with DILI ingest more than one potentially hepatotoxic agent.

I don't know, that would be a very good question to ask....Let me know what your doctor says. [QUOTE=SnowOwl]Not to make this about me, but I'm clearly brewing two probable infections, sinus, maybe strep (throat's dark red, sore, red spots all over the uvula), and I scratched my gum last night while tending my teeth and the scratch has grown over the day into an infected nasty patch that hurts like the devil, despite salt water rinses.  I see my GP tomorrow morning and I'm pretty sure I'll be given antibiotics.   Does someone who is on a standard short-term course of ABs have to worry about their liver? [/QUOTE]

My understanding is that all meds go through your liver, so the more meds you are on, the more work it is doing.  But...can you get over infections like strep without abx?  I think some infections require abx or else you risk getting extremely sick.

I hope you feel better soon!
I'm sorry you're feeling so bad

 

Hang in there...I hope you start feeling better soon sorry, Snow....... I've been just where you are and too recently for it not to be an ugly memory.

 

good luck!!

wait.  You take your MTX daily? [QUOTE=SnowOwl] LOL...no..

You're certainly not your usual self today....... Here's hoping you are quickly on the mend.

Sno! So sorry you are ill- hope you get better fast. Darn- they probably will make you stop your MTX. Hope it doesn't bother you like it did me. I wonder why they excluded acetaminophen?  I mean, its the cause of most liver failures statistically - heck, even an old study on that is on the linked page???

 

I'd be interested to see the final study as it's not in Pubmed yet.  When I looked up the lead author he's got one study on statins being a major cause of liver failure.

 

This study is less than a year old and says this about statins too -

 

Of the types of drugs implicated, cardiovascular agents (angiotensin-converting enzyme inhibitors, angiotensin II inhibitors, statins, and fibrates) and central nervous system (CNS) drugs were the most frequent cause of chronic injury (28.5% and 25%, respectively). Interestingly, in the cases of acute, self-limited injury, antibiotics and nonsteroidal anti-inflammatory drugs were the most common offenders, a finding consistent with earlier reports (Hepatology 2002;36:451–455; Aliment Pharmacol Ther 2006;24:1187–1195). Cardiovascular and CNS drugs were much less common in the acute, self-limited group, accounting for 9.8% and 13%, respectively.

 

http://www.gastrojournal.org/article/PIIS0016508507006233/fulltext

 

At least the antibiotics are in the self-limiting group, no?

 

Hugs,

 

Pip

[QUOTE=Pip!]I wonder why they excluded acetaminophen?  I mean, its the cause of most liver failures statistically - heck, even an old study on that is on the linked page???[/quote]
And THAT fact is most likely why it was excluded.

Check this previous discussion pertaining to the same link and the same question.
[QUOTE=wanttobeRAfree]Sno! So sorry you are ill- hope you get better fast. Darn- they probably will make you stop your MTX. Hope it doesn't bother you like it did me. [/QUOTE]

 

but, as we discussed at the time, I didn't hve to stop MTX... only stopped enbrel.

 

Best to you again, Snow!!

Snow - my daughter could take azithromycin with mtx, but not amoxicillin.  I think you are safe!  Take care and hope it helps!

edited in case nobody understood my abx abbreviations.
Suzanne2009-04-14 12:11:29 [QUOTE=SnowOwl] oh my goodness SnowOwl. Hope you are feeling better soon!
I really like my regular gp. She's sharp as a tack. She even carries around a palm pilot type of thing that tells her if there are any potential interactions between all the prescribed meds. I did try to switch doctors once, so that I could see someone who was only 10minutes away instead of 25 minutes away. Big mistake. I told the doctor that I had RA and listed my meds. When he gave me the abx for my bladder infection I asked him if it was ok to take this abx with mtx. He said he didn't know and what was mtx for again? uhh...I decided that a 25 minute drive wasn't too much after all.

I wish you a speedy return to your former fabulousness! [QUOTE=Suzanne] [QUOTE=SnowOwl]
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