and Chronic Liver Diseases
Chronic hepatitis patients sometimes need to use antibiotics for unrelated
infections and various surgical and dental procedures. Many are not sure
about the possible harmful effects some antibiotics may cause their liver
so I will try to provide a general guide here.
The liver has very complicated functions and one of the most important is
the detoxification of drugs such as antibiotics and its metabolites. Some
antibiotics can cause allergic reactions while others can cause direct
damage to their liver, which can be quite severe in patients with chronic
liver disease. For patients with a pre-existing liver disorder, the
detoxification function of the liver is already compromised and substances
that would normally be metabolized could actually accumulate in the liver
or in the bloodstream. Antibiotics that accumulate in this manner could
become toxic to the body and its functions can change drastically from its
The following is a list of the most common antibiotics groups being used
today. Each is ordered according to their potential harmful effects on the
liver, the top group being the most potentially harmful and the last group
being the least.
1. Tetracycline family
following antibiotics belong to this family: Tetracycline, Minocylinum,
Guamecycline, Oxytetracycline, Doxycyline, Methacycline, and
Demethylchlortetracycline. When used in larger doses, antibiotics in this
family can cause jaundice, fever, and fatty liver. Hepatitis patients
should be very wary of this group and alert their doctor immediately of
their liver condition and ask for substitutes.
2. Erythromycin family
following antibiotics belong to this family: Erythromycin, Erythromycin
Estotate, Erythromycin ethylsuccinate. These antibiotics can cause
damage to the liver via cholestasis (bile retention) and jaundice. The
harmful effects usually start to show after 10 to 14 days’ use and the
incidence rate is approximately 5 to 10%. Clinically, patients may
experience stomachache, nausea, vomiting, jaundice, and elevation of liver
enzymes. These conditions are often considered allergic reactions since
the incidence rate is not very high.
3. Chloramphenicolum family.
following antibiotics belong to this family: Chloramphenicolum,
Chloramphenicol Palmitate, Thiamphenicol and Chloramphenicoli Succinas.
When metabolized in the liver, they combined with glucoronic acid and lose
their anti-microbial effects. This combination of antibiotics and
glucoronic acid can accumulate in the bloodstream, which can cause bone
marrow inhibition. As a result, WBC and RBC counts can drop and patients
with hepatitis should try to avoid this group if they can.
4. Penicillin family.
following antibiotics belong to this family: Benzylpenicillin, Benzathine
penicillin, Phenoxymethylpenicillin, Oxacillin Sodium, Cloxacillin,
Dicloxacillin, Ampicillin Sodium, Ampicloxacillin sodium, Pvampicillin,
Amoxicillin, Carbenicillin sodium, Talampicillin, Furbenicillin,
Mecillinam, Carindacillin sodium, Ticarcillin. These antibiotics cause the
least liver damage and only patients who are allergic may experience some
side effects. Generally, antibiotics in the penicillin family are the most
“liver friendly” and safe for chronic hepatitis patients to use.
For chronic hepatitis patients who need a substitute and patients who need
long-term antibiotics treatment for Lyme disease or other infections,
herbal anti-microbial agents can be used. Our most effective herbal
solutions for infections are: Allicin Capsule, Coptis Capsule, HH Capsule,
and Rhubarbin Tablet.