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The Annals of Pharmacotherapy: Vol. 37, No. 3, pp. 395-397. DOI 10.1345/aph.1C273
© 2003 Harvey Whitney Books Company.
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Recurrent Cholestasis Due to Ampicillin

Seyfettin Köklü, MD

Research Fellow, Department of Gastroenterology, Türkiye Yüksek Ihtisas Hospital, Ankara, Turkey

Osman Yüksel, MD

Research Fellow, Department of Gastroenterology, Türkiye Yüksek Ihtisas Hospital

Levent Filik, MD

Research Fellow, Department of Gastroenterology, Türkiye Yüksek Ihtisas Hospital

Oguz Üsküdar, MD

Research Fellow, Department of Gastroenterology, Türkiye Yüksek Ihtisas Hospital

Kadri Altundag, MD

Associate Professor, Department of Medical Oncology, Hacettepe University Institute of Oncology, Ankara

Emin Altiparmak, MD

Instructor, Department of Gastroenterology, Türkiye Yüksek Ihtisas Hospital

Reprints: Seyfettin Köklü MD, Department of Gastroenterology, Türkiye Yüksek Ihtisas Hospital, Orman Genel Müdürlügü Lojmanlari, 86 / 3, 06560-Gazi, Ankara, Turkey, FAX 90-312-3242009, E-mail gskoklu{at}yahoo.com

OBJECTIVE: To present a single case of ampicillin-induced recurrent cholestasis and a literature review.

CASE SUMMARY: A 23-year-old man was hospitalized due to recurrent and self-limited cholestatic symptoms. He had used ampicillin before each cholestatic attack. He became well clinically and biochemically each time after cessation of the drug. One year after his recovery and discontinuance of ampicillin, the patient has had no recurrence of cholestasis. An objective causality assessment revealed that the adverse drug reaction was probable.

DISCUSSION: Ampicillin-related hepatotoxicity is very rare, with injury being mainly hepatocellular. To our knowledge, there is only 1 case report in the literature referring to chronic cholestatic-type hepatotoxicity related to ampicillin.

CONCLUSIONS: Ampicillin, which is one of the most widely used antibiotics, may cause recurrent cholestatic hepatitis. Clinicians should be aware of this adverse effect, and it should be kept in mind during diagnostic workup of liver injury.

Key Words: ampicillin, cholestatic hepatitis

Published Online, January 27, 2003. www.theannals.com, DOI 10.1345/aph.1C273


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S. Koklu, A. S Koksal, M. Asil, H. Kiyici, S. Coban, and M. Arhan
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