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Title: Resolution of norfloxacin-induced acute liver failure after N-acetylcysteine therapy: further support for the use of NAC in drug-induced ALF?
Austin Authors: Elliott, Timothy Ross;Symes, Tiffany;Kannourakis, George;Angus, Peter W 
Affiliation: University of Melbourne, Melbourne, Victoria, Australia
Pathology Department, St John of God Hospital, Ballarat, Victoria, Australia
Ballarat Oncology and Haematology, Ballarat, Victoria, Australia
Victorian Liver Transplant Unit and Department of Gastroenterology, Austin Health, Heidelberg, Victoria, Australia
Issue Date: 6-Jan-2016 2016-01-06
Publication information: BMJ Case Reports 2016; 2016: bcr-2015-213189
Abstract: Liver injury due to idiosyncratic drug reactions can be difficult to diagnose and may lead to acute liver failure (ALF), which has a high mortality rate. N-acetylcysteine (NAC) is effective treatment for paracetamol toxicity, but its role in non-paracetamol drug-induced ALF is controversial. We report on the use of a validated bedside tool to establish causality for drug-induced liver injury (DILI) and describe the first case of resolution of norfloxacin-induced ALF after NAC therapy. NAC is easy to administer and generally has a good safety profile. We discuss the evidence to support the use of NAC in ALF secondary to DILI and possibilities for further clinical research in this field.
DOI: 10.1136/bcr-2015-213189
PubMed URL:
Type: Journal Article
Subjects: Acetylcysteine
Anti-Bacterial Agents
Drug-Induced Liver Injury
Appears in Collections:Journal articles

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