Antimicrobial-Induced Hepatotoxicity: A Pharmacological Review

Authors

Keywords:

antimicrobials, hepatotoxicity, DILI, idiosyncraticmechanisms, genetic polymorphisms

Abstract

Antimicrobials are frequently associated with drug-induced liver injury (DILI), accounting for up to 50% of cases. Due to their widespread use, assessing hepatic risk is essential. A total of 284 relevant scientific sources were analyzed from international databases (PubMed, Scopus, Medline, etc.). Antimicrobial-induced hepatotoxicity can present as hepatocellular, cholestatic, mixed liver injury, hepatic steatosis, or autoimmune hepatitis. The most frequently implicated agents include amoxicillin-clavulanate, minocycline, rifampin, isoniazid, erythromycin, azole antifungals, and fluoroquinolones. Mechanisms involve immune-mediated responses, mitochondrial dysfunction, and the formation of toxic metabolites. Hepatotoxicity caused by antimicrobials is a complex phenomenon influenced by both drug-related and patient-specific factors. Understanding these mechanisms is essential for preventing and managing hepatotoxicity in clinical practice.

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Published

2025-10-01

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No. 2(104) (2025): Supliment. Al VI-lea Congres Național de Gastroenterologie și Hepatologie din Republica Moldova cu participare internațională

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[1]
Catcov, C. et al. 2025. Antimicrobial-Induced Hepatotoxicity: A Pharmacological Review. Public Health, Economy and Management in Medicine. 2(104) (Oct. 2025), 34–40.

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