Student or educator? Sign up with your school email and get 6 months of Pro free.
CoChat
Sign Up
Cited by 12

The DOI matches its Crossref record; 3 of the 3 references it cites were found in a registry or an index.

The Frequency of Drug-Induced Liver Injury Due to Antibiotics Among Hospitalised Patients

Björnsson, Robert A, Sigurdsson, Sigurdur Sölvi, Arnarson, Dagur Tjörvi, Logason, Egill, Björnsson, Einar Stefan·2025·Drug Safety
DOI 10.1007/s40264-025-01541-w
Open this paper in CoChat — free account

Abstract

Introduction Most epidemiological studies have found antibiotics to be the most common cause of drug-induced liver injury (DILI). It is unclear what the risk of DILI is associated with different antibiotics. Objective The aim of the study was to assess the frequency of DILI due to the most commonly used antibiotics among inpatients, in a population-based setting. Methods Patients who were treated with the 14 most-used antibiotics at Landspitali University Hospital Iceland 2012-2023, with concomitant: > 5 × upper limit of normal (ULN) of alanine aminotransferase (ALT) and/or > 2 × ULN of alkaline phosphatase (ALP), were identified. If DILI was a potential cause, the Revised Electronic Causality Assessment Method (RECAM) method was used to determine likelihood of DILI. Results Overall 2292 patients fulfilled the inclusion criteria, 52 of whom were found to have DILI, median age 67 (range 21-93) years, 58% females, 17 (33%) with jaundice and three (5.8%) died of liver failure. The most commonly implicated agent was amoxicillin/clavulanate (n = 23) in 1:1327 users (0.075%), ceftriaxone (n = 8) 1:3779 (0.02%), cefazolin (n = 7) 1: 6363 (0.016%), cloxacillin 1:6024 (n = 4) (0.017%), piperacillin/tazobactam (n = 2) 1:1551 (0.097%), vancomycin (n = 2) 1:1966 (0.076%), trimethoprim-sulfamethoxazole (TMP/SMX) (n = 3) 1:1096 (0.091%) and ciprofloxacin (n = 1) 1:10,938 (0.009%). In two cases, more than one antibiotic was considered likely. Conclusions Drug-induced liver injury was found…

Overview

Integrity signals

Registry

Crossref · 10.1007/s40264-025-01541-w

Cites

3 of 3 references verified0 citation errors · 0 not checkable

Statistics

Recomputing p-values needs the paper’s full text.

Verification

Claims the paper makes

This paper’s full text isn’t openly available, so its claims and self-check weren’t run. The registry and citation checks still apply.

Claims other papers make about this one

Each is checked against this paper’s own text: does it say what the citing paper says it does?

Citations

Cites

Show all 3 references

Research works printed but not linked: 25

  1. Björnsson E, Olsson R. Outcome and prognostic markers in severe drug-induced liver disease. Hepatology. 2005;42:481–9. · DOI · Paper page
  2. Chalasani N, Bonkovsky HL, Fontana R, Lee W, Stolz A, Talwalkar J, et al. Features and outcomes of 899 patients with drug-induced liver injury: the DILIN prospective study. Gastroenterology. 2015;148:1340-52.e7. · DOI · Paper page
  3. Stephens C, Robles-Diaz M, Medina-Caliz I, Garcia-Cortes M, Ortega-Alonso A, Sanabria-Cabrera J, et al. Comprehensive analysis and insights gained from long-term experience of the Spanish DILI Registry. J Hepatol. 2021;75:86–97. · DOI · Paper page
  4. Bessone F, Hernandez N, Mendizabal M, Sanchez A, Paraná R, Arrese M, et al. When the creation of a consortium provides useful answers: experience of the Latin American DILI network (LATINDILIN). Clin Liver Dis (Hoboken). 2019;13:51–7. · DOI
  5. Devarbhavi H, Joseph T, Sunil Kumar N, Rathi C, Thomas V, Singh SP, et al. The indian network of drug-induced liver injury: etiology, clinical features, outcome and prognostic markers in 1288 patients. J Clin Exp Hepatol. 2021;11:288–98. · DOI · Paper page
  6. Björnsson ES, Stephens C, Atallah E, Robles-Diaz M, Alvarez-Alvarez I, Gerbes A, et al. A new framework for advancing in drug-induced liver injury research. The Prospective European DILI Registry. Liver Int. 2023;43:115–26. · DOI · Paper page
  7. Björnsson B, Bergqvist A, Jerlstad P, Olsson R. Fulminant drug-induced hepatic failure leading to death or liver transplantation in Sweden. Scand J Gastroenterol. 2005;40:1095–101. · DOI · Paper page
  8. Wei G, Bergquist A, Broome U, Lindgren S, Wallerstedt S, Almer S, Sangfeldt P, et al. Acute liver failure in Sweden: etiology and outcome. J Intern Med. 2007;262:392–401. · DOI
  9. Björnsson ES, Hoofnagle JH. Categorization of drugs implicated in causing liver injury: critical assessment based upon published case reports. Hepatology. 2016;63:590–603. · DOI · Paper page
  10. de Abajo FJ, Montero D, Madurga M, Garcia Rodrigues LA. Acute and clinically relevant drug-induced liver injury: a population based case-control study. Br J Clin Pharmacol. 2004;58:71–80. · DOI · Paper page
  11. Suzuki A, Tillmann H, Williams J, Hauser RG, Frund J, Suzuki M, et al. Assessment of the frequency, phenotypes, and outcomes of acute liver injury associated with amoxicillin/clavulanate in 1.4 million patients in the Veterans Health Administration. Drug Saf. 2023;46:129–43. · DOI
  12. Kang Y, Kim S-H, Park SY, Park BY, Lee JH, An J, et al. Evaluation of drug-induced liver injury developed during hospitalization using electronic health record (HER)-based algorithm. Allergy Asthma Immunol Res. 2020;12:430–42. · DOI
  13. https://www.ncbi.nlm.nih.gov/books/NBK547852/
  14. Alqahtani SA, Kleiner DE, Ghabril M, Gu J, Hoofnagle JH, Rockey DC. Identification and characterization of cefazolin-induced liver injury. Dig Dis Sci. 2016;61:2406–16. · DOI
  15. Aithal GP, Watkins PB, Andrade RJ, Larrey D, Molokhia M, Takikawa H, et al. Case definition and phenotype standardization in drug-induced liver injury. Clin Pharmacol Ther. 2011;89:806–15. · DOI · Paper page
  16. De Valle MB, Av Klinteberg V, Alem N, Olsson R, Björnsson E. Drug-induced liver injury in a Swedish University hospital out-patient hepatology clinic. Aliment Pharmacol Ther. 2006;24:1187–95. · DOI · Paper page
  17. Sgro C, Clinard F, Ouazir K, Chanay H, Allard C, Guilleminet C, et al. Incidence of drug-induced hepatic injuries: a French population-based study. Hepatology. 2002;36:451–5. · DOI · Paper page
  18. Shin J, Hunt CM, Suzuki A, Papay JI, Beach KJ, Cheetham TC. Characterizing phenotypes and outcomes of drug-associated liver injury using electronic medical record data. Pharmacoepidemiol Drug Saf. 2013;22:190–8. · DOI · Paper page
  19. Chen VL, Rockey DC, Bjornsson ES, Barnhart H, Hoofnagle JH. Incidence of idiosyncratic drug-induced liver injury caused by prescription drugs. Drug Saf. 2024;48:151–60. · DOI
  20. Kwon H, Lee SH, Kim SE, Lee JH, Jee YK, Kang HR, et al. Spontaneously reported hepatic adverse drug events in Korea: multicenter study. J Korean Med Sci. 2012;27:268–73. · DOI
  21. Pedraza L, Laosa O, Rodríguez-Mañas L, et al. Drug induced liver injury in geriatric patients detected by a two-hospital prospective pharmacovigilance program: a comprehensive analysis using the Roussel Uclaf causality assessment method. Front Pharmacol. 2020;11: 600255. · DOI
  22. Cabanas R, Calderon O, Ramirez E, Fiandor A, Prior N, Caballero T, et al. Piperacillin-induced DRESS: distinguishing features observed in a clinical and allergy study of 8 patients. J Investig Allergol Clin Immunol. 2014;24:425–30.
  23. Rao A, Rule JA, Hameed B, Ganger D, Fontana RJ, Lee WM. Secular trends in severe idiosyncratic drug-induced liver injury in North America: an update from the acute liver failure study group registry. Am J Gastroenterol. 2022;117:617–26. · DOI
  24. Gekhman D, Correa E. One DOSE of cefazolin—months of misery: a case of acute liver failure with grave consequences: 3039. Am J Gastroenterol. 2018;113:S1664–5. · DOI
  25. deLemos AS, Ghabril M, Rockey DC, Gu J, Barnhart H, Fontana RJ, et al. Amoxicillin-clavulanate-induced liver injury. Dig Dis Sci. 2016;61:2406–16. · DOI

Cited by

See all 12

Metadata

Authors
Björnsson, R. A., Sigurdsson, S. S., Arnarson, D. T., Logason, E., & Björnsson, E. S.
ORCID
Björnsson, Einar Stefan
Venue
Drug Safety
Publisher
Springer Science and Business Media LLC
Published
2025-03-12
Volume
48
Issue
7
Pages
795-804
ISSN
  • 0114-5916
  • 1179-1942
DOI
10.1007/s40264-025-01541-w
Cited by
12
References
3
Language
en
Licence

About these checks

Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.

Statistics and arithmetic are recomputed, not judged.

Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.

What counts as a claim ›How we measure confidence ›How we check this ›

Are you an author, or do you see a problem with this page? Request a review

How to cite

Cite CoChat for the checks on this page, and the paper for its own findings.

This page
CoChat. (2026). Citation check: The Frequency of Drug-Induced Liver Injury Due to Antibiotics Among Hospitalised Patients. https://app.cochat.ai/papers/10.1007/s40264-025-01541-w
The paper
Björnsson, R. A., Sigurdsson, S. S., Arnarson, D. T., Logason, E., & Björnsson, E. S. (2025). The Frequency of Drug-Induced Liver Injury Due to Antibiotics Among Hospitalised Patients. Drug Safety. https://doi.org/10.1007/s40264-025-01541-w

Data sources

Bibliographic data: Semantic Scholar, OpenAlex, Crossref.

Contains information from the Semantic Scholar Academic Graph Datasets, made available under the ODC Attribution License (ODC-BY 1.0).

Semantic Scholar’s data is described in: Kinney, R., et al. (2023). The Semantic Scholar Open Data Platform. arXiv:2301.10140.