LIVER FAILURE

Liver damage linked to levofloxacin

The latest package insert for Levaquin (May 2008) now includes
NUMEROUS updated warnings concerning fatal liver
damage following levaquin therapy.
Click here to read more...

Dear Doctor Letters sent by Bayer regarding SEVERE adrs to Avelox, February 14, 2008

BMJ 1997;314:869 (22 March, 1997) Quinolones may induce hepatitis

Health Canada, Note to Editors - January 3, 2007
In this Issue: Levofloxacin: Dysglycemia and Liver disorders

Non-Fatal Acute Liver Injury Possibly Related to High-Dose Ciprofloxacin

Mechanistic Study on Flumequine Hepatocarcinogenicity Focusing on DNA Damage in Mice
Yoko Kashida*, Yu F. Sasaki, Koh-ichi Ohsawa, Natsue Yokohama, Akiko Takahashi*, Takao Watanabe* and Kunitoshi Mitsumori
"... the results of the present study provide evidence that FL was not only a hepatic tumor promoter but also a hepatic tumor initiator."

Trovafloxacin, a quinolone antibiotic, is an idiosyncratic hepatotoxin. Further analysis revealed unique regulation of 142 genes, including some involved in RNA transcription.

Levofloxacin-induced acute fulminant hepatic failure in a patient with chronic hepatitis B infection.

Adverse events associated with pyrazinamide and levofloxacin in the treatment of latent multidrug-resistant tuberculosis

Incidence of Serious Side Effects from First-Line Antituberculosis Drugs among Patients Treated for Active Tuberculosis "...In more recent studies, the incidence of drug-induced hepatitis was 18% in patients taking levofloxacin (Levoquin) and PZA for 6 months..."}

Non-Fatal Acute Liver Injury Possibly Related to High-Dose Ciprofloxacin 
 M. Goetz, P. R. Galle, A. Schwarting   A1 Medical Clinic I, University of Mainz, Langenbeckstrasse 1, 55131, Mainz, Germany

Acute hepatitis associated with oral levofloxacin therapy in a hemodialysis patient.
 CMAJ 2003 Apr 1;168(7):847-8 (ISSN: 0820-3946) Schwalm JD; Lee CH  Department of Pathology and Molecular Medicine, McMaster University, Hamilton, ON.

Acute hepatitis associated with levaquin in a patient with renal insufficiency taking amiodarone June 25, 2003

Acute hepatitis associated with oral levofloxacin therapy in a hemodialysis patient.

Possible ciprofloxacin-induced acute cholestatic jaundice

Ciprofloxacin-induced acute liver injury: case report and review of literature

Gatifloxacin-Associated Acute Hepatitis

Suspected ciprofloxacin-induced hepatotoxicity

Hepatitis Associated with Amoxicillin/Clavulanic Acid and/or Ciprofloxacin.

Ciprofloxacin-induced glutathione redox status alterations in rat tissues.

Effects of ciprofloxacin on fetal hepatocytes.

Possible Levofloxacin-Induced Acute Hepatocellular Injury in a Patient with Chronic Obstructive Lung Disease
Anita Karim,1 Shahid Ahmed,1 Leonard J. Rossoff,1 Rina K. Siddiqui,2 and Harry N. Steinberg1

Possible gatifloxacin-induced fulminant hepatic failure.
Coleman CI, Spencer JV, Chung JO, Reddy P.
Infection with Basidiobolus ranarum in two dogs {treated with enrofloxacin resulting in possible liver damage.}
Greene CE, Brockus CW, Currin MP, Jones CJ.  Department of Small Animal Medicine, College of Veterinary Medicine, University of Georgia, Athens 30602, USA.

Acute liver failure due to trovafloxacin: CT findings
H. K. Pannu A1, L. Gottlieb A2, E. K. Fishman A1

Antimicrobial-Associated Acute Hepatitis {associated with Levofloxacin, Gatifloxacin}
Susan C. Nicholson, M.D., C. Douglas Webb, Ph.D., and Robert C. Moellering, Jr., M.D.

Quinolones may induce hepatitis
BMJ 1997;314:869 (22 March)  Drug points 

Ciprofloxacin-induced acute liver injury: case report and review of literature   Annette Zimpfer1, Albert Propst2, Gregor Mikuz3, Wolfgang Vogel2, Luigi Terracciano1 and Sylvia Stadlmann3 (1) Institute of Pathology, University of Basel, Schoenbeinstrasse 40, 4003 Basel, Switzerland  (2) Department of Gastroenterology and Hepatology, University Hospital Innsbruck, Anichstrasse 35, 6020 Innsbruck, Austria  (3) Institute of Pathology, University of Innsbruck, Muellerstrasse 44, 6020 Innsbruck, Austria

Effects of ciprofloxacin on foetal hepatocytes.
J Pak Med Assoc. 2003 Oct;53(10):448-50.  Channa MA, Janjua MZ.  Department of Anatomy, Basic Medical Sciences Institute, Jinnah Postgraduate Medical Centre, Karachi.

Fulminant hepatic failure possibly related to ciprofloxacin  BK Grassmick, VT Lehr, and AS Sundareson

Antibiotic-associated hepatitis: update from 1990
T Vial, M Biour, J Descotes, and C Trepo
"The most important recent information is the possibility of protracted liver cholestasis with bile duct injuries induced by several antibiotics, particularly penicillinase-resistant penicillins, and the identification of new potentially hepatotoxic antibiotics, namely, roxithromycin, ciprofloxacin, and trimethoprim. "

Acute liver failure: Clinical features, outcome analysis, and applicability of prognostic criteria   A. Obaid Shakil 1 *, David Kramer 2, George V. Mazariegos 3, John J. Fung 3, Jorge Rakela
"Demographic and Etiologic Features of Patients With Acute Liver Failure ... Ampicillin clavulanate, 1 patient; antabuse, 2 patients; ciprofloxacin, 1 patient ... "

Delayed and prolonged cholestatic hepatitis with ductopenia after long-term ciprofloxacin therapy for Crohn's disease. 
 Hepatol. 2002 Nov;37(5):696-9. Bataille L, Rahier J, Geubel A.  Department of Gastroenterology and Pathology, Saint Luc University Hospital, Universite Catholique de Louvain, 10 Avenue Hippocrate, 1200 Brussels, Belgium.

Fatal subfulminant hepatic failure with ofloxacin
Am J Gastroenterol. 2000 Jun;95(6):1606. .Gonzalez Carro P, Huidobro ML, Zabala AP, Vicente EM.

Trovafloxacin-associated leukopenia.
Ann Pharmacother. 2001 Jan;35(1):41-4. Mitropoulos FA, Angood PB, Rabinovici R. Yale New Haven Hospital, New Haven, CT, USA.
Trovafloxacin-Induced Acute Hepatitis
M. Isabel Lucena,1 Raúl J. Andrade,2 Luis Rodrigo,3 Javier Salmerón,4 Arancha Alvarez,3 M. J. Lopez-Garrido,4 Raquel Camargo,2 and Ramiro Alcantára2

Adverse events associated with pyrazinamide and levofloxacin in the treatment of latent multidrug-resistant tuberculosis
Tina Papastavros, Lisa R. Dolovich, Anne Holbrook, Lori Whitehead, and Mark Loeb

The following references have no abstract or full text available to the general public.  Some of these articles however are available for a fee on several Internet Sites such as Springer, Blackwell Synergy, etc, or from the publication cited:

Norfloxacin-Induced Cholestatic Jaundice
(full text can be purchased from Blackwell Synergy by following this link)
 American Journal of Gastroenterology
Volume 93 Issue 11 Page 2309 - November 1998
doi:10.1111/j.1572-0241.1998.02309.x
M. Isabel Lucena, Ph.D.a*Raul J. Andrade, Ph.D.bHerminia Sanchez-Martinez, M.D.cJose Manuel Perez-Serrano, M.D.cAntonio Gomez-Outes, M.D.daClinical Pharmacology Service Department of Gastroenterology University Hospital, School of Medicine University of Malaga Málaga, Spain Liver Unit Department of Gastroenterology University Hospital, School of Medicine University of Malaga Málaga, Spain Department of Internal Medicine Hospital La Inmaculada Huercal-Overa, Almeria, SpaindClinical Pharmacology Service Department of Gastroenterology University Hospital, School of Medicine University of Malaga Málaga, Spain

Norfloxacin-induced eosinophilic necrotizing granulomatous hepatitis
(full text can be purchased from Blackwell Synergy by following this link)
American Journal of Gastroenterology
Volume 95 Issue 12 Page 3662 - December 2000
doi:10.1111/j.1572-0241.2000.03404.x
Einar BjornssonBjörnssona, Rolf Olssonab, Helen RemottibaDepartment of Internal Medicine, Sahlgrenska University Hospital, Göteborg, SwedenbDepartment of Pathology, New York Presbyterian Hospital, Weill Cornell Medical Center, New York, New York, USA

Norfloxacin-Induced Acute Cholestatic Hepatitis in a Patient With Alcoholic Liver Cirrhosis
(full text can be purchased from Blackwell Synergy by following this link)
American Journal of Gastroenterology
Volume 94 Issue 8 Page 2324 - August 1999
doi:10.1111/j.1572-0241.1999.02324.x
Manuel Romero-Gómez, M.D.a
Emilio Suarez Garcia, M.D.a
M. Castro Fernández, M.D.aaDigestive Unit
Hospital Universitario de Valme
Sevilla, Spain

Antibiotic-associated hepatitis: update from 1990
T Vial, M Biour, J Descotes, and C Trepo

Am J Gastroenterol. 2002 Jul;97(7):1853-4. Related Articles, Links
Moxifloxacin-induced acute liver injury.
Soto S, Lopez-Roses L, Avila S, Lancho A, Gonzalez A, Santos E, Urraca B.
http://www.blackwell-synergy.com/doi/abs/10.1111/j.1572-0241.2002.05873.x?cookieSet=1

A 32-Year-Old Man with Hepatitis C Who Developed Progressive Liver Failure after a Bone Marrow Transplant 
DIAGNOSTIC PROBLEMS IN HEPATOLOGY   Semin Liver Dis 2002; 22: 103-108  DOI: 10.1055/s-2002-23211   Andre C. Lyra1 M.D. , Elizabeth M. Brunt2 M.D. , Steven Pincus3 M.D. Ph.D. , Adrian M. Di Bisceglie1 M.D. FACP  1: Division of Gastroenterology and Hepatology, Department of Internal Medicine, Saint Louis University School of Medicine, St. Louis, Missouri   2: Department of Pathology, Saint Louis University School of Medicine, St. Louis, Missouri 3: Division of Hematology and Oncology, Department of Internal Medicine, Saint Louis University School of Medicine, St. Louis, Missouri

Acute fatal hepatitis related to levofloxacin
J Hepatol. 2001 Aug;35(2):308-9..Spahr L, Rubbia-Brandt L, Marinescu O, Armenian B, Hadengue A

Fatal subfulminant hepatic failure with ofloxacin
American Journal of Gastroenterology Volume 95 Issue 6 Page 1606 - June 2000 doi:10.1111/j.1572-0241.2000.02118.x  P. González Carro, M.D.a, M. L. Legaz Huidobro, M.D.a, A. Pinardo Zabala, M.D.a, and E. Muńoz Vicente, M.D.baDigestive Unit, Hospital General "Mancha-Centro" Alc´zar de San Juan, Ciudad Real, SpainbPathology, Hospital General "Mancha-Centro" Alc´zar de San Juan, Ciudad Real, Spain

Norfloxacin-induced eosinophilic necrotizing granulomatous hepatitis
American Journal of Gastroenterology
Volume 95 Issue 12 Page 3662 - December 2000
doi:10.1111/j.1572-0241.2000.03404.x  Einar BjornssonBjörnssona, Rolf Olssonab, Helen RemottibaDepartment of Internal Medicine, Sahlgrenska University Hospital, Göteborg, SwedenbDepartment of Pathology, New York Presbyterian Hospital, Weill Cornell Medical Center, New York, New York, USA

Liver disfunction due to ciprofloxacin.
Acta Gastroenterol Belg. 1995 Sep-Dec;58(5-6):475-6. Alcalde M, Donoso MS, Carcfa-Diaz M, Pascasio JM, Narvaez I.

Norfloxacin-Induced Cholestatic Jaundice
American Journal of Gastroenterology Volume 93 Issue 11 Page 2309 - November 1998 doi:10.1111/j.1572-0241.1998.02309.x   M. Isabel Lucena, Ph.D.a*Raul J. Andrade, Ph.D.bHerminia Sanchez-Martinez, M.D.cJose Manuel Perez-Serrano, M.D.cAntonio Gomez-Outes, M.D.daClinical Pharmacology Service Department of Gastroenterology University Hospital, School of Medicine University of Malaga Málaga, SpainbLiver Unit Department of Gastroenterology University Hospital, School of Medicine University of Malaga Málaga, SpaincDepartment of Internal Medicine Hospital La Inmaculada Huercal-Overa, Almeria, SpaindClinical Pharmacology Service Department of Gastroenterology University Hospital, School of Medicine University of Malaga Málaga, Spain

Ciprofloxacin induced bradycardia: A case report
LETTER Year : 1994 | Volume : 26 | Issue : 2 | Page : 164 Dhobi GN, Shafiqa TA Correspondence Address: Dhobi G N

Jarisch-Herxheimer reaction associated with ciprofloxacin administration for tick-borne relapsing fever. "Liver function tests revealed a total bilirubin of 1.3 mg/dl, an aspartate ... She was
prescribed a 3-day course of oral ciprofloxacin (500 mg twice a day) and ... " Pediatric Infectious Disease Journal. 21(6):571-573, June 2002. Webster, Gregory B.A.; Schiffman, Joshua D. M.D.; Dosanjh, Amarjit S. B.S.; Amieva, Manuel R. M.D., Ph.D.; Gans, Hayley A. M.D.; Sectish, Theodore C. M.D.

Is Ciprofloxacin a New Cause of Acute Pancreatitis? "... difficile enterocolitis, and abnormalities of liver biochemistry. As far as we know, acute pancreatitis has not been described after taking ciprofloxacin. ... "
Journal of Clinical Gastroenterology. 31(4):336, December 2000.
Mann, Steven M.R.C.P.; Thillainayagam, Andrew M.D., M.R.C.P.

CIPROFLOXACIN-INDUCED ACUTE RENAL FAILURE IN A PATIENT WITH CYSTIC FIBROSIS.
Pediatric Infectious Disease Journal. 20(3):320-321, March 2001.
Bald, Martin M.D.; Ratjen, Felix M.D.; Nikolaizik, Winfried M.D.; Wingen, Ann-Margret M.D.

Norfloxacin-induced eosinophilic necrotizing granulomatous hepatitis
American Journal of Gastroenterology
Volume 95 Issue 12 Page 3662 - December 2000
doi:10.1111/j.1572-0241.2000.03404.x  Einar BjornssonBjörnssona, Rolf Olssonab, Helen RemottibaDepartment of Internal Medicine, Sahlgrenska University Hospital, Göteborg, SwedenbDepartment of Pathology, New York Presbyterian Hospital, Weill Cornell Medical Center, New York, New York, USA

Fatal hepatic failure associated with ciprofloxacin.
Lancet. 1994 Mar 19;343(8899):738-9. Comment in: Lancet. 1994 May 7;343(8906):1163. (Lancet. 1994 May 7;343(8906):1163. Who is withholding information?) Pfeiffer M, Reiter C.  Fuchs S, Simon Z, Brezis M.

Norfloxacin induced hepatitis.
Davoren P, Mainstone K. Med J Aust 1993;159:423.

Ofloxacin induced acute severe hepatitis.
Blum A.  South Med J 1991;84:1158.

Acute Eosinophilic Hepatitis from Trovafloxacin
H. J.L. Chen, K. J. Bloch, and J. A. Maclean N. Engl. J. Med., February 3, 2000; 342(5): 359 - 360. Date: April 2001  Pages: 925 - 926 CASE REPORT: Trovafloxacin Hepatotoxicity Dariusz A. Lazarczyk, Neal S. Goldstein and Stuart C. Gordon

Case Report: Cholestatic Jaundice Induced by Ciprofloxacin
Publisher: Springer Science+Business Media B.V., Formerly Kluwer Academic Publishers B.V. ISSN: 0163-2116 (Paper) 1573-2568 (Online) DOI: 10.1023/A:1018870029216  Issue: Volume 42, Number 1 Date: January 1997  Pages: 192 - 194  Jodie K. Labowitz and William B. Silverman

Fulminant toxic epidermal necrolysis induced by trovafloxacin.
Matthews MR, Caruso DM, Phillips BJ, Csontos LG.
Arch Intern Med. 1999 Oct 11;159(18):2225. Related Articles, Links
http://archinte.ama-assn.org/cgi/content/full/159/18/2225