ArticleClinical gastroenterology and hepatology : the official clinical practice journal of the American Gastroenterological Association2011
Clinical and histopathologic features of fluoroquinolone-induced liver injury.
Article in Clinical gastroenterology and hepatology : the official clinical practice journal of the American Gastroenterological Association, 2011. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 63 papers.
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63 citing papers in PubMed, 130 citations in OpenAlex.
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- HLA-B*44 Alleles and HLA-DQA1*03:01 as Genetic Risk Factors for Drug-Induced Liver Injury due to Fluoroquinolones.Liver international : official journal of the International Association for the Study of the Liver · 2026Article
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- Use of oral fluoroquinolones in France between 2014 and 2023: a nationwide drug utilization study.JAC-antimicrobial resistance · 2025Article
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- Antibacterial Mechanisms and Clinical Impact of Sitafloxacin.Pharmaceuticals (Basel, Switzerland) · 2024Review
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- Safety of fluoroquinolones.Revista espanola de quimioterapia : publicacion oficial de la Sociedad Espanola de Quimioterapia · 2024Review
- A blinded in vitro analysis of the intrinsic immunogenicity of hepatotoxic drugs: implications for preclinical risk assessment.Toxicological sciences : an official journal of the Society of Toxicology · 2023Article
- Levofloxacin-Induced Hepatotoxicity in Patients With Legionnaires' Disease: Implications and Management.Cureus · 2023Article
- Drug-Induced Liver Injury with Commonly Used Antibiotics in the All of Us Research Program.Clinical pharmacology and therapeutics · 2023Article
- Overview of Side-Effects of Antibacterial Fluoroquinolones: New Drugs versus Old Drugs, a Step Forward in the Safety Profile?Pharmaceutics · 2023Review
- Liver Damage and microRNAs: An Update.Current issues in molecular biology · 2022Review
- Acute Immunoallergic Hepatitis in the Presence of Crohn's Disease: A Case Presentation and Review of the Literature.Cureus · 2022Article
- Oral Fluoroquinolone Use and the Risk of Acute Liver Injury: A Nationwide Cohort Study.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2022Article
- Systemic quinolones and risk of retinal detachment III: a nested case-control study using a US electronic health records database.European journal of clinical pharmacology · 2022Article
- Healthcare costs and mortality associated with serious fluoroquinolone-related adverse reactions.Pharmacology research & perspectives · 2022Article
- Dose- and time-dependent manners of moxifloxacin induced liver injury by targeted metabolomics study.Frontiers in pharmacology · 2022Article
- Moxifloxacin Induced Liver Injury by CausingDisease markers · 2022Article
3 more citing papers are in PubMed but not listed here.
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Authors and funding
8 authors at 5 institutions in 1 country.
Funding
Abstract
BACKGROUND &
aimsFluoroquinolone-induced liver injury is rare; no prospective studies of well-characterized case series have been published. We studied patients with fluoroquinolone-induced hepatotoxicity from the Drug-Induced Liver Injury Network (DILIN) to characterize injury patterns, outcomes, and associated features.
methodsWe identified subjects with fluoroquinolone hepatotoxicity enrolled in the DILIN from September 2004 to January 2010. Demographic, clinical, and laboratory data were analyzed by descriptive statistical methods.
resultsOf the 679 registrants in the DILIN prospective study, 12 had fluoroquinolone hepatotoxicity (6 ciprofloxacin, 4 moxifloxacin, 1 levofloxacin, and 1 gatifloxacin). Seven were women; median age was 57 years (range, 23-80 years), and median time from fluoroquinolone start to symptoms was only 4 days (range, 1-39 days). Nine patients developed symptoms on medication; 3 did so 2, 8, and 32 days after stopping the medication. Cases were equally distributed among hepatocellular injury (predominantly increased levels of alanine aminotransferase), cholestatic injury (predominantly increased levels of alkaline phosphatase), and both. Seven patients had immunoallergic features. Patients with mixed hepatocellular and cholestatic injury had mild disease without jaundice; all recovered. In contrast, 2 of 4 patients with hepatocellular injury and jaundice died, 1 of acute liver failure. One patient with cholestatic injury developed vanishing bile duct syndrome and required liver transplantation; another had a persistently increased serum level of alkaline phosphatase.
conclusionsFluoroquinolone liver injury is rapid in onset and often has immunoallergic features, indicating a hypersensitivity reaction. The pattern of injury can be hepatocellular, cholestatic, or mixed; mixed cases are the least severe. Acute and chronic liver failure can occur.
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