Fatal fulminant hepatitis following administration of clarithromycin in a patient chronically treated with antipsycotic drugs

Abstract

Background: Clarithromycin is a widely used antibiotic, especially prescribed for the treatment of respiratory tract infections, The drug is generally well tolerated. It is described as a very rare cause of fulminant liver failure.

Case presentation: Herein we report a case of fatal fulminant hepatitis in a young patient. In his past history the patient presented documented episodes of hypertransaminasemia.

Conclusions: This case confirms that clarithromycin although very rarely, can be a cause of fulminant hepatitis, especially in patients with pre-existing liver damage. Although the presumption that clarithromycin hepatotoxicity is dose related is reasonable, an immune-toxicologic hypothesis cannot be excluded.

Keywords::

• Clarithromycin
• fulminant hepatitis
• hepatic toxicity
• antibiotic
• immunology

Acknowledgement

P.M. and B.S. coordinated the study (P.M. supervised the infectivological and pharmacological aspects of the case report, B.S. the medico-legal aspects. A.L. and E.M. collected the data respectively from the infectivologic and medico-legal point of view. P.C. and L.T. drafted the manuscript respectively from the infectivologic and medico-legal point of view. G.A. revised and gave the final approval of the version to be published. All authors read and approved the final manuscript.

Declaration of interest

The authors declare that they have no competing interests