Stricker B H, Van den Broek J W, Keuning J, Eberhardt W, Houben H G, Johnson M, Blok A P
Netherlands Centre for Monitoring of Adverse Reactions to Drugs, Rijswijk.
Dig Dis Sci. 1989 Oct;34(10):1576-80. doi: 10.1007/BF01537113.
Five case histories are presented of patients developing cholestatic hepatitis associated with the intake of the antibiotic combination agent amoxicillin and clavulanic acid (Augmentin). In two of these cases, signs of hepatic injury recurred after readministration of this combination but not after the intake of amoxicillin alone. In none of the patients was another cause for cholestatic hepatitis found and extrahepatic causes were excluded by ultrasonography, CT scanning, or ERCP. Most viral causes of hepatic injury were excluded in these patients. With the exception of one patient, who developed a transient rash, no immunoallergic signs were present. Biopsy in two patients showed extensive cholestasis without significant necrosis. Clavulanic acid seems to be responsible for this adverse effect.
本文介绍了5例患者的病史，这些患者在摄入抗生素联合制剂阿莫西林和克拉维酸（安灭菌）后发生胆汁淤积性肝炎。其中2例患者再次服用该联合制剂后肝损伤体征复发，但单独服用阿莫西林后未复发。所有患者均未发现胆汁淤积性肝炎的其他病因，通过超声、CT扫描或内镜逆行胰胆管造影术排除了肝外病因。这些患者排除了大多数肝损伤的病毒病因。除1例出现短暂皮疹的患者外，均无免疫过敏体征。2例患者的活检显示广泛胆汁淤积，无明显坏死。克拉维酸似乎是造成这种不良反应的原因。
