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Dr. Andrew Rynne

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Cirrhotic patient, sinus infection, allergic to penicillin and Sulfa. Levofloxin or Erthromycin?

Answered by
Dr.
Dr. Poorna Chandra K.S

Gastroenterologist

Practicing since :2000

Answered : 339 Questions

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Posted on Sat, 19 May 2012 in Liver and Gall Bladder
Question: Antibiotics-liver disease :

=================
Could you please tell me if Levofloxin or Erthromycin are safe for a cirrhotic patient to take for a sinus infection. If not could you please recommend a safe alternative. The person in question is allergic to penicillin and Sulfa. Is there a website that specifies what antibiotics are and are not safe in this situation. Thank you
doctor
Answered by Dr. Poorna Chandra K.S 3 hours later
Dear,

All antibiotics are metabolised in the liver and hence have some effect on the liver.

In the setting of cirrhosis, penicillin group of antibiotics are the safest. It’s unfortunate that this patient is allergic to pencillin so cannot be used.
Quinolones like Levofloxacin are routinely used to prevent infections in cirrhotic and are also safe. Erythromycin can cause some cholestatic features (raised ALP, pruritus) if used on a prolonged basis (> 2wks).

Unless you are educated in pharmacology or medicine you should rely on your doctor for these informations rather than the net as there is always a risk of misunderstanding and interpretation. A medical literature will list all possible side effects including those found in 1 in 0000 and they have to be interpreted correctly. Still if you are very particular you may go through this article - WWW.WWWW.WW
Hope this answers your query.

Wish you good health.

Regards
Dr XXXXXXX

Above answer was peer-reviewed by : Dr. Prasad
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