Hepatotoxicity of antibacterials: Pathomechanisms and clinical

Infection. 2010 Feb;38(1):3-11. doi: 10.1007/s15010-009-9179-z. Epub 2010 Jan 27.


Drug-induced hepatotoxicity is a frequent cause of liver disease and acute liver failure, particularly in patients treated with multiple drugs. Several antibacterial drugs have the potential to cause severe liver injury and failure. This article aims to increase the awareness and understanding of drug induced liver injury (DILI) due to antibacterial drugs. It reviews the pattern of antibacterial DILI and provides details on molecular mechanisms and toxicogenomics, as well as clinical data based on epidemiology studies. Certain antibacterial drugs are more frequently linked to hepatotoxicity than others. Therefore, the hepatotoxic potential of tetracyclines,sulfonamides, tuberculostatic agents, macrolides, quinolones,and beta-lactams are discussed in more detail. Efforts to improve the early detection of DILI and the acquisition of high-quality epidemiological data are pivotal for increased patient safety.

Publication types

  • Review

MeSH terms

  • Anti-Bacterial Agents / adverse effects*
  • Anti-Bacterial Agents / therapeutic use
  • Anti-Bacterial Agents / toxicity*
  • Bacterial Infections / drug therapy*
  • Chemical and Drug Induced Liver Injury*
  • Humans
  • Liver / drug effects*


  • Anti-Bacterial Agents