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A rare case of cefepime-induced cholestatic liver injury


1 Department of Pharmacy, Taipei Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, New Taipei, Taiwan
2 Division of Pulmonary Medicine, Department of Internal Medicine, Taipei Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, New Taipei; School of Medicine, Tzu Chi University, Hualien, Taiwan
3 Division of Pulmonary Medicine, Department of Internal Medicine, Taipei Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, New Taipei, Taiwan

Correspondence Address:
Hsin-Yi Chen,
Division of Pulmonary Medicine, Department of Internal Medicine, Taipei Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, 289, Jianguo Road, Xindian District, New Taipei
Taiwan
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/tcmj.tcmj_151_18

Cefepime is widely used in the hospital setting, and only a few studies have reported neurotoxicity and nephrotoxicity as side effects of this drug. Herein, we present a 93-year-old man who exhibited features of cholestatic hepatitis including elevated blood transaminases and direct-form predominant bilirubin levels after administration of cefepime. Blood liver tests showed total recovery after discontinuing the offending agent. Cefepime was probable to cause drug-induced cholestatic hepatitis in our patient since the Roussel Uclaf Causality Assessment Method score for cefepime was 7. No drug interactions were likely according to the Drug Interaction Probability Scale for this patient. No similar cases of cholestatic drug-induced liver injury related to cefepime have been reported previously. Hence, this rare condition requires a high degree of clinical suspicion for prompt diagnosis and treatment.


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