Hepatotoxicity associated with intravenous clindamycin phosphate therapy is reported in a drug abuser cured of staphylococcal endocarditis. Coincident with the administration of large doses of clindamycin, marked hepatic enzyme abnormalities were noted, and liver biopsy showed lobular disruption, pseudogranulomas, hepatocyte necrosis, eosinophilic bodies and mononuclear cell infiltration. Cessation of clindamycin therapy resulted in return of liver enzymes to normal, and a second liver biopsy performed 15 days later showed improvement. Reports of clindamycin-associated hepatic enzyme changes are reviewed; further observation for clindamycin-associated hepatotoxicity is warranted.
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