Objective: To estimate the risk of cholestatic hepatitis of uncertain
origin in patients who had recently received erythromycin, a drug whic
h is known to cause this disorder. Design: A retrospective cohort stud
y using data automatically recorded on general practitioners' office c
omputers. Setting: Some 600 general practices in the United Kingdom. S
ubjects: 366 064 people who received erythromycin. Main outcome measur
e: Clinically documented cholestatic hepatitis of uncertain origin dia
gnosed 1-45 days after a prescription for erythromycin. Results: There
were 13 cases of cholestatic hepatitis of uncertain origin diagnosed
within 45 days of receiving erythromycin which were either characteris
tic of or consistent with a syndrome previously described as being ass
ociated with this drug. Conclusion: The risk of cholestatic jaundice a
ssociated with erythromycin is estimated to be in the range of 3.6 per
100 000 users (95% confidence interval, 1.9-6.1).