Pancreatitis Induced by Clarithromycin
Authors: Leibovitch Liviu
Journal: Annals of Internal Medicine (1996)

Letters15 October 1996Pancreatitis Induced by ClarithromycinLeibovitch Liviu, MD, Levy Yair, MD, and Shoenfeld Yehuda, MDLeibovitch Liviu, MDSheba Medical Center, Tel-Hashomer 51621, Israel, Levy Yair, MDSheba Medical Center, Tel-Hashomer 51621, Israel, and Shoenfeld Yehuda, MDSheba Medical Center, Tel-Hashomer 51621, IsraelAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-125-8-199610150-00031 SectionsAboutVisual AbstractPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail TO THE EDITOR:Clarithromycin is a relatively new macrolide antibiotic that to our knowledge has not previously been associated with pancreatitis. The older macrolide, erythromycin, is a well-established drug known to cause pancreatitis [1, 2]. We report the first case of clarithromycin-induced pancreatitis.A 58-year-old healthy woman reported dry cough persisting for 1 month without fever. Results of a physical examination were unremarkable. Chest radiography showed diffuse interstitial markings in the lungs. The working diagnosis was atypical pulmonary infection, and clarithromycin was begun at a dosage of 500 mg twice daily. Five days after treatment began, the patient reported severe vomiting, nausea, and mild epigastric pain and was referred to our hospital. On admission, the results of physical examination were normal except for mild epigastric tenderness. Laboratory findings showed hyperamylasemia (amylase level, 1200 IU/mL; normal range, 150 to 400 IU/mL) and hyperlipasemia (lipase level, 80 IU/mL; normal range, 4 to 33 IU/mL). The patient was hospitalized for observation, and clarithromycin therapy was discontinued. After 3 days of conservative treatment, symptoms resolved and amylase and lipase levels returned to normal. Ultrasonography of the abdomen showed no cholelithiasis, dilatation of the choledecus, or pancreatic abnormality. The patient was not alcoholic, and no causes for her pancreatitis other than clarithromycin could be determined.Clarithromycin is emerging as a commonly used antibiotic for respiratory infections. Clinicians should be aware of this serious side effect of the drug.References1. Haksworth CR. Acute pancreatitis associated with infusion of erythromycin lactobionate. Br Med J. 1989; 298:190. Google Scholar2. Gumaste VV. Erythromycin-induced pancreatitis. Am J Med. 1989; 86:725. Google Scholar Comments0 CommentsSign In to Submit A Comment Author, Article, and Disclosure InformationAffiliations: Sheba Medical Center, Tel-Hashomer 51621, Israel PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics Cited ByEver-increasing diversity of drug-induced pancreatitisDrug induced pancreatitis: A systematic review of case reports to determine potential drug associationsMacrolides and KetolidesDrug-induced acute pancreatitis related to medications commonly used in gastroenterologyDrug-Induced PancreatitisAcute Pancreatitis in a Patient Treated with MicafunginDrug-Induced Acute Pancreatitis: An Evidence-Based ReviewTowards patient-related information needsUpdate on the use of the macrolides for community-acquired respiratory tract infectionsAcute pancreatitis and modified-release clarithromycinThe evolution and role of macrolides in infectious diseasesThe macrolidesThe Macrolides: Erythromycin, Clarithromycin, and AzithromycinMacrolide antibioticsClarithromycin 15 October 1996Volume 125, Issue 8Page: 701KeywordsAntibioticsLipasesPancreatitisPatientsPulmonary diseasesResearch laboratoriesThoraxUltrasound imagingUpper respiratory tract infectionsVomiting Issue Published: 15 October 1996 CopyrightCopyright © 1996 by American College of Physicians. All Rights Reserved.PDF DownloadLoading ...