Ofloxacin-induced fulminant hepatitis : a case report

Ofloxacin-induced fulminant hepatitis : a case report

INTRODUCTION

C. JOYAU1, G. VEYRAC1, A. DEININGER2, L. TRIQUET3, F. DELAMARRE-DAMIER4, P. JOLLIET1,5
(1) Clinical Pharmacology Department, Biology Institute, University Hospital, Nantes, France ;
(2) Pharmacy, Saint Nazaire Hospital, Saint Nazaire, France ;
(3) Department of Pharmacovigilance Center, Pontchaillou University Hospital, Rennes, France ;
(4) Coordinating physician of nursing home «Montfort», Saint Laurent sur Sèvre, France and Hospital Practioner, Cholet Hospital, France ;
(5) EA 4275 «Biostatistics, Pharmacoepidemiology and Subjectives Health Measures», Medicine University, Nantes


Fluoroquinolones (FLQ) are synthetic antibiotics widely used for treatment of bacterial infections in elderly patients. The profile of adverse effects consists of headache, dizziness, seizures, confusion, diplopia, peripheral neuropathy, photosensibility, tendinopathy, kidney failure, pseudomembranous colitis, psychiatric effects. FLQ are also known to cause liver enzymes increase. Indeed, the FLQ may be responsible for liver disorders ranging from asymptomatic elevated liver enzymes to fulminant hepatitis responsible for death. This hepatotoxicity is considered as a class effect of FLQ. Fulminant hepatitis is a side effect reported in the summary of products characteristics of some FLQ,
In European database of suspected adverse drug reactions reports (Eudravigilance), 67 cases of fulminant hepatitis are reported with FLQ: 8 fatal cases with ofloxacin, 12 cases with ciprofloxacin (including 9 deaths), 32 cases with levofloxacin (including 19 deaths) and 15 cases with moxifloxacin (including 12 deaths).
We report a fatal case of a patient treated with ofloxacin who developed fulminant hepatitis.

 

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