Antibiotics and the liver. Only one group is liver friendly

[Upbeat]

Antibiotics and Chronic Liver Diseases
Antibiotics and Chronic Liver Diseases
Chronic hepatitis patients sometimes need to use antibiotics for unrelated infections and various surgical and dental procedures. Many are not sure about the possible harmful effects some antibiotics may cause their liver so I will try to provide a general guide here.

The liver has very complicated functions and one of the most important is the detoxification of drugs such as antibiotics and its metabolites. Some antibiotics can cause allergic reactions while others can cause direct damage to their liver, which can be quite severe in patients with chronic liver disease. For patients with a pre-existing liver disorder, the detoxification function of the liver is already compromised and substances that would normally be metabolized could actually accumulate in the liver or in the bloodstream. Antibiotics that accumulate in this manner could become toxic to the body and its functions can change drastically from its original purpose.

The following is a list of the most common antibiotics groups being used today. Each is ordered according to their potential harmful effects on the liver, the top group being the most potentially harmful and the last group being the least.


1. Tetracycline family

The following antibiotics belong to this family: Tetracycline, Minocylinum, Guamecycline, Oxytetracycline, Doxycyline, Methacycline, and Demethylchlortetracycline. When used in larger doses, antibiotics in this family can cause jaundice, fever, and fatty liver. Hepatitis patients should be very wary of this group and alert their doctor immediately of their liver condition and ask for substitutes.


2. Erythromycin family

The following antibiotics belong to this family: Erythromycin, Erythromycin Estotate, Erythromycin ethylsuccinate. These antibiotics can cause damage to the liver via cholestasis (bile retention) and jaundice. The harmful effects usually start to show after 10 to 14 days’ use and the incidence rate is approximately 5 to 10%. Clinically, patients may experience stomachache, nausea, vomiting, jaundice, and elevation of liver enzymes. These conditions are often considered allergic reactions since the incidence rate is not very high.

3. Chloramphenicolum family.

The following antibiotics belong to this family: Chloramphenicolum, Chloramphenicol Palmitate, Thiamphenicol and Chloramphenicoli Succinas. When metabolized in the liver, they combined with glucoronic acid and lose their anti-microbial effects. This combination of antibiotics and glucoronic acid can accumulate in the bloodstream, which can cause bone marrow inhibition. As a result, WBC and RBC counts can drop and patients with hepatitis should try to avoid this group if they can.


4. Penicillin family.

The following antibiotics belong to this family: Benzylpenicillin, Benzathine penicillin, Phenoxymethylpenicillin, Oxacillin Sodium, Cloxacillin, Dicloxacillin, Ampicillin Sodium, Ampicloxacillin sodium, Pvampicillin, Amoxicillin, Carbenicillin sodium, Talampicillin, Furbenicillin, Mecillinam, Carindacillin sodium, Ticarcillin. These antibiotics cause the least liver damage and only patients who are allergic may experience some side effects. Generally, antibiotics in the penicillin family are the most "liver friendly" and safe for chronic hepatitis patients to use.



--------------------------------------------------------------------------------

[GrandmaA]

Thanks for the information. Hopefully, I won't have anymore infections in the next 12 weeks.

[Forseegood]

thanks so much for this, I have an anti-biotic issue with the kid I take care of...she keeps getting UTI's and the doc keeps giving her Keflex which is strange, I would think if she keeps getting them with this Keflex, he should change horses...I'm taking her to another doc....if anyone has anything to add, I'd be grateful, meanwhile, thanks so mcuh for this...be well...

[lackalustre]

thanks for this INFO!!!    Some of these antibiiotics can actually put us into liver failure.  i carry a list in my purse.   and i have known that the penicillin family is the safest for us!!   thanks again.

[hippygem]

Hi there, would you be able to provide the link as to where you got this information from.

Thanks

[Eisbein]

Aim To estimate the risk of acute liver injury associated with the use of
drugs.

Methods In a population survey study, 126 cases of acute liver injury were
prospectively assembled from January 1993 to December 1999, in patients over
15 years of age, in 12 hospitals in Barcelona (Spain). We estimated the
relative risk for each drug as the ratio between the incidence of acute
liver injury among the exposed population to the drug and the incidence of
acute liver injury among those not exposed to it. Drug consumption data were
used to estimate the exposed population.

Results Isoniazid, pyrazinamide, rifampicin, amoxicillin with clavulanic
acid, erythromicin, chlorpromazine, nimesulide, and ticlopidine presented
the highest risk (point relative risk > 25). Amoxicillin, metoclopramide,
captopril and enalapril, furosemide, hydrochlorothiazide, fluoxetine,
paroxetine, diazepam, alprazolam, lorazepam, metamizole, low-dose
acetylsalicylic acid and salbutamol showed the lowest risk (point relative
risk < 5).

Conclusions This study provides a risk estimation of serious liver disease
for various drugs that will be useful in its diagnosis and management, and
when comparing with the drug therapeutic benefit in each indication. Some
observed associations would be worth specific studies.

http://www.blackwell-synergy.com/doi/abs/10.1111/j.1365-2036.2007.03338.x

Ina

[jmjm530]

Hippy to Upbeat: Hi there, would you be able to provide the link as to where you got this information from.
----------------------------------------------------------------

Hippy,

The article in question comes from "AllOnHealth.com", a commerical health site that sells herbal remedies, colon cleansers, supplements, etc. No studies cited in the article.

My liver specialist has Ok'd some of the antibiotics in the 'bad' "Tetracycline" group even while on treatment. Running any drug by your doctor is always a good idea, but stating that "hepatitis patients should be very wary of this group and ask for substitutes" seems alarmist.

http://allonhealth.com/liver-cleanse/antibiotocs-liver.htm

-- Jim

[jmjm530]

For accuracy, there should have been a "..." inserted in the above quote, as such:

"Hepatitis patients should be very wary of this group...and ask for substitutes."

[hippygem]

Thanks Jim.