The risk of liver damage associated with minocycline: A comparative study

Using the General Practice Research Database, the authors performed (1) a c ohort analysis comparing the incidence of liver dysfunction in new users of minocycline with new users of oxytetracyclineltetracycline and (2) a case control study assessing antibiotic exposure in new cases of liver dysfuncti on and controls without liver dysfunction. In new users, the incidence of l iver dysfunction in those exposed to minocycline was 1.04 cases/10,000 expo sed person months (EPM) and 0.69 cases/10,000 EPM in those exposed to oxyte tracyclineltetracycline (relative risk 1.51 [CI95: 0.63, 3.65]). The risk i n both groups was greatest in the first month of use. The adjusted odds rat io (ORadj) of liver dysfunction associated with exposure to minocycline com pared with nonuse was 2. 10 (CI95: 1.30, 3.40); for oxytetracycline/tetracy cline, the ORadj was 1.46 (CI95: 0.81, 2.64); and for exposure to erythromy cin, the ORadj was 1.64 (CI95: 0.71, 3.80). The authors thus support a weak association between the use of oral antibiotics and liver dysfunction in p atients with acne. The risk associated with exposure to minocycline appears to be very small. The cohort analysis demonstrated that any risk associate d with minocycline was not significantly greater than that associated with oxytetracyclineltetracycline exposure. (C) 2001 the American College of Cli nical Pharmacology.