A rare case of metronidazole induced recurrent pancreatitis

Qian, Changtao; Abourizk, Nicholas; Rizk, Michelle-Ashley; Kim, Jinah; Smith, Debi Lisa; Westra, Kevin; McLaughlin, John P.

doi:10.1016/j.pan.2020.11.001

Cited by 2 publications

(1 citation statement)

References 8 publications

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“…Metronidazole has been mentioned in several case reports on PA, with three patients having a positive rechallenge and all having a favorable outcome [29]. Based on these data, it is classified as class Ia according to both the classification of Roberto Simons-Linares et al and the classification of Diana Wolfe et al We would like to point out that three other cases have been described in the literature that are not included in this narrative review, two of them with a positive rechallenge [11,12,30].…”

Section: Metronidazole and 5-nitroinidazolesmentioning

confidence: 93%

Drug-Induced Acute Pancreatitis in Adults: Focus on Antimicrobial and Antiviral Drugs, a Narrative Review

Del Gaudio,

Covello,

Di Vincenzo

et al. 2023

Antibiotics

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Acute pancreatitis (AP) is an acute inflammation of the pancreas caused by the activation of digestive enzymes in the pancreatic tissue. The main causes of AP are cholelithiasis and alcohol abuse; less commonly, it can be caused by drugs, with a prevalence of up to 5%. Causal associations between drugs and pancreatitis are largely based on case reports or case series with limited evidence. We reviewed the available data on drug-induced AP, focusing on antimicrobial drugs and antivirals, and discussed the current evidence in relation to the classification systems available in the literature. We found 51 suspected associations between antimicrobial and antiviral drugs and AP. The drugs with the most evidence of correlation are didanosine, protease inhibitors, and metronidazole. In addition, other drugs have been described in case reports demonstrating positive rechallenge. However, there are major differences between the various classifications available, where the same drug being assigned to different probability classes. It is likely that the presence in multiple case reports of an association between acute pancreatitis and a drug should serve as a basis for conducting prospective randomized controlled trials to improve the quality of the evidence.

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