Azithromycin-induced intrahepatic cholestasis

Azithromycin (Zithromax), an erythromycin derivative that belongs to a subgroup of the macrolides known as azolides, has generally been considered to be a very safe medication. Hepatic side effects are uncommon but may include jaundice, fever, and right upper quadrant pain. Herein we describe a patient who developed azithromycin-induced cholestatic hepatitis that resolved upon discontinuation of the drug. Lack of other known causes for liver disease, the temporal relationship with this drug, and the typical changes of liver histology have established the diagnosis. Clinicians should be aware of this side effect of azithromycin, which is widely prescribed.