Hepatotoxicitatea indusă de antimicrobiene: revizuire farmacologică

Autori

Cuvinte cheie:

antimicrobiene, hepatotoxicitate, DILI, mecanismeidiosincrazice, polimorfisme genetice

Rezumat

Rezultatele cercetărilor relevă că antimicrobienele sunt implicate în circa 50% din cazurile de hepatotoxicitate indusă de medicamente (DILI). Utilizarea lor necesită evaluarea riscului hepatotoxic. A fost efectuată o analiză a 284 de surse științifice relevante, identificate în baze de date internaționale (PubMed, Scopus, Medline etc.). Hepatotoxicitatea indusă de antimicrobiene se poate manifesta prin leziuni hepatocelulare, colestatice, mixte, steatoză hepatică sau hepatită autoimună. Antimicrobienele cel mai frecvent implicate sunt: amoxicilinăclavulanat, minociclină, rifampicină, isoniazidă, eritromicină, itraconazol, voriconazol, fluocitozină, terbinazină și TVX. Reacțiile imune, disfuncțiile mitocondriale și formarea de metaboliți toxici s-au dovedit a fi principalele mecanisme implicate în leziunile hepatice. Hepatotoxicitatea indusă de antimicrobiene se consideră un fenomen complex, influențat de proprietățile medicamentelor și factorii individuali. Înțelegerea mecanismelor implicate devine esențială pentru prevenirea și gestionarea reacțiilor adverse hepatice în practica clinică.

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Publicat

01.10.2025

Cum cităm

[1]
Catcov, C. et al. 2025. Hepatotoxicitatea indusă de antimicrobiene: revizuire farmacologică. Sănătate Publică, Economie şi Management în Medicină. 2(104) (Oct. 2025), 34–40.

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