Page 86 - JCTR-11-1

Journal of Clinical and
Translational Research Meropenem-induced cholestasis

to rapid liver function recovery. In this case, cessation Ethics approval and consent to participate
of meropenem led to significant improvement in liver
function within weeks, highlighting the reversible nature The author certifies that he/she has obtained all appropriate
of drug-induced liver injury when detected early. Patients patient consent forms.
receiving meropenem should undergo regular liver Consent for publication
function monitoring, especially those with pre-existing
liver disease or those receiving concomitant hepatoxic In the patient consent form, the patient(s) has/have given
medications. A baseline liver enzyme assessment should his/her/their consent for his/her/their clinical information
be performed before therapy initiation, with regular to be reported in the journal. The patients understand that
follow-up testing throughout treatment. 12 their names and initials will not be published and due
efforts will be made to conceal their identity, but anonymity
Clinicians should maintain a high index of suspicion cannot be guaranteed.
for drug-induced liver injury in patients presenting
with jaundice or elevated liver enzymes, particularly Availability of data
when recent antibiotic therapy is involved. Other
potential causes, such as viral hepatitis, autoimmune All data generated and/or analyzed during this study are
liver disease, or biliary obstruction, must be ruled out included in this published article.
through appropriate investigations. In addition, patient References
education is essential. Patients should be informed about
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and pruritus, and should be advised to report these action of carbapenem resistance. Antibiotics. 2022;11(3):421.
symptoms promptly. Interdisciplinary collaboration doi: 10.3390/antibiotics11030421
among pharmacists, nurses, and physicians can enhance 2. Armstrong T, Fenn SJ, Hardie KR. JMM profile:
monitoring efforts and improve overall patient safety Carbapenems: A broad-spectrum antibiotic. J Med
during antibiotic therapy. Microbiol. 2021;70(12):001462.
4. Conclusion doi: 10.1099/jmm.0.001462

Meropenem is a critical agent in the management of serious 3. Tattersall T, Wright H, Redmond A. Meropenem-induced
infections; however, its potential to induce cholestasis liver injury and beta-lactam cross-reactivity. BMJ Case
Rep. 2018;11(1):e227124.
warrants careful consideration. This case underscores the
necessity for routine liver function monitoring in patients doi: 10.1136/bcr-2018-227124
receiving meropenem and highlights the importance of 4. Shiraishi C, Kato H, Ogura T, Iwamoto T. An investigation
early recognition and intervention to prevent significant of broad-spectrum antibiotic-induced liver injury based on
liver injury. Further research is needed to elucidate the the FDA adverse event reporting system and retrospective
underlying mechanisms of drug-induced cholestasis and observational study. Sci Rep. 2024;14(1):18221.
to identify patient-specific risk factors that could inform doi: 10.1038/s41598-024-69279-6
safer prescribing practices in the future.
5. Hartwig SC, Siegel J, Schneider PJ. Preventability and
Acknowledgment severity assessment in reporting adverse drug reactions. Am
J Hosp Pharm. 1992;49(9):2229-2232.
The authors acknowledge and support the untiring
efforts and the contribution of the Pharmacovigilance 6. Schumock GT, Thornton JP. Focusing on the preventability
of adverse drug reactions. Hosp Pharm. 1992;27(6):538.
Programme of India toward ensuring better patient safety
nationwide. 7. Danan G, Teschke R. RUCAM in drug and herb induced
liver injury: The update. Int J Mol Sci. 2016;17(1):14.
Funding doi: 10.3390/ijms17010014
None. 8. Fish DN. Meropenem in the treatment of complicated
skin and soft tissue infections. Ther Clin Risk Manag.
Conflict of interest 2006;2(4):401-15.
The author declares no competing interest. doi: 10.2147/tcrm.2006.2.4.401

Author contributions 9. Kullak-Ublick GA. Drug-induced cholestatic liver disease.
In: Madame Curie Bioscience Database. Austin, TX: Landes
This is a single-authored article. Bioscience; 2000-2013. Available from: https://www.ncbi.

Volume 11 Issue 1 (2025) 80 doi: 10.36922/jctr.24.00072