Dept. of Internal Medicine I, Medical University of Vienna, General Hospital of Vienna, Austria.
Infection. 2010 Feb;38(1):3-11. doi: 10.1007/s15010-009-9179-z. Epub 2010 Jan 27.
Drug-induced hepatotoxicity is a frequent cause of liver disease and acute liver failure, particularly in patients treated with multiple drugs. Several antibacterial drugs have the potential to cause severe liver injury and failure. This article aims to increase the awareness and understanding of drug induced liver injury (DILI) due to antibacterial drugs. It reviews the pattern of antibacterial DILI and provides details on molecular mechanisms and toxicogenomics, as well as clinical data based on epidemiology studies. Certain antibacterial drugs are more frequently linked to hepatotoxicity than others. Therefore, the hepatotoxic potential of tetracyclines,sulfonamides, tuberculostatic agents, macrolides, quinolones,and beta-lactams are discussed in more detail. Efforts to improve the early detection of DILI and the acquisition of high-quality epidemiological data are pivotal for increased patient safety.
药物性肝损伤是肝病和急性肝衰竭的常见病因,尤其在接受多种药物治疗的患者中更为常见。一些抗菌药物具有导致严重肝损伤和衰竭的潜力。本文旨在提高对抗菌药物引起的药物性肝损伤(DILI)的认识和理解。本文回顾了抗菌药物 DILI 的模式,并提供了有关分子机制和毒代基因组学的详细信息,以及基于流行病学研究的临床数据。某些抗菌药物比其他药物更常与肝毒性相关。因此,本文更详细地讨论了四环素类、磺胺类、抗结核药物、大环内酯类、喹诺酮类和β-内酰胺类的肝毒性潜力。改善 DILI 的早期检测和获取高质量的流行病学数据的努力对于提高患者安全性至关重要。