Analysis of clinical characteristics and influential factors of drug-induced liver injury in children caused by intravenous azithromycin
- VernacularTitle:静脉滴注阿奇霉素致儿童药物性肝损伤的临床特征及影响因素分析
- Author:
Wanhui LI
1
;
Xiaoqian LYU
1
;
Dan SU
1
;
Baofeng HUO
1
;
Hejun CHEN
2
;
Ping YAN
1
Author Information
1. Dept. of Pediatric Internal Medicine，Hengshui People’s Hospital，Hebei Hengshui 053000，China
2. Dept. of Pharmacy，Hengshui People’s Hospital，Hebei Hengshui 053000，China
- Publication Type:Journal Article
- Keywords:
azithromycin;
drug-induced liver injury;
children
- From:
China Pharmacy
2025;36(20):2566-2570
- CountryChina
- Language:Chinese
-
Abstract:
OBJECTIVE To analyze the clinical characteristics and influential factors of drug-induced liver injury （DILI） in children caused by intravenous azithromycin. METHODS Clinical data of 157 DILI pediatric cases caused by intravenous azithromycin， reported by the Hengshui Adverse Drug Reaction Monitoring Center from January 2015 to January 2025， were collected as the observation group. Clinical data of pediatric patients who received intravenous azithromycin but did not develop DILI during the same period at Hengshui People’s Hospital were collected in a 1∶1 ratio to serve as the control group. The clinical classification， severity and prognosis of DILI in pediatric patients from the observation group were analyzed. Univariate and multivariate Logistic regression analyses were used to screen the independent risk factors for DILI in children caused by intravenous azithromycin. RESULTS Among 157 DILI cases， 92 cases （58.60%） had hepatocellular injury-type， 51 cases （32.48%） had cholestatic-type， and 14 cases （8.92%） had mixed-type. DILI severity was grade 1 in 117 cases （74.52%）， grade 2 in 33 cases （21.02%）， and grade 3 in 7 cases （4.46%）. Liver function had all recovered after stopping medication and symptomatic treatment. Combined with acetaminophen [OR＝3.769， 95%CI （1.615， 8.235）， P＝0.021]， daily dose of azithromycin＞10 mg/kg [OR＝ 2.237， 95%CI （1.075， 4.655）， P＝0.034] were independent risk factors for DILI in children caused by intravenous azithromycin. CONCLUSIONS Hepatocellular injury-type and cholestatic-type are relatively common in children with DILI caused by intravenous azithromycin， with mild severity being predominant and showing a favorable prognosis. Combination with acetaminophen and daily dose＞10 mg/kg are independent risk factors for azithromycin-induced DILI in children.
