Hepatotoxixity associated to the use of amoxicillin-clavulanic acid

We report of 72 years old diabetic male that, after the use of combined amo xicillin-clavulanic acid, developed pruritus and jaundice. Liver function t ests showed serum total bilirubin of 4.3 mg/dL aspartate aminotransferase 1 40 U/l (normal <35 U/L), alanine aminotransferase 470 U/L (normal <40) and alkaline phosphatases of 400 U/L (normal <100). Serology for hepatitis A, B and C viruses was negative, ERCP showed a normal biliary tree and liver bi opsy disclosed a cholestatic hepatitis. Ursodeoxycholic was started to reli eve pruritus. Liver function tests improved shortly thereafter, suggesting that this drug may be useful in the treatment of drug induced cholestasis.