{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T01:36:12Z","timestamp":1787016972557,"version":"build-2736575974"},"reference-count":14,"publisher":"BMJ","issue":"1","license":[{"start":{"date-parts":[[2018,11,1]],"date-time":"2018-11-01T00:00:00Z","timestamp":1541030400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/www.bmj.com\/company\/legal-information\/terms-conditions\/legal-information\/tdm-licencepolicy"}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Rep"],"accepted":{"date-parts":[[2018,11,8]]},"published-print":{"date-parts":[[2018,11]]},"abstract":"<jats:p>A 63-year-old man admitted to hospital for the management of a frontal lobe abscess developed elevated liver enzymes within 48\u2009hours of receiving meropenem. Liver enzymes reached a maximum at 5 days postadministration of meropenem, with alanine aminotransferase 1160 U\/L, aspartate aminotransferase 787 U\/L, alkaline phosphatase 297 U\/L and gamma-glutamyltransferase 252 U\/L. Meropenem was ceased and liver function normalised. Meropenem was administered for a second time later in the patient\u2019s admission and again the patient developed rapidly increasing liver enzymes, with a mixed hepatocellular\/cholestatic pattern. Other possible causes of liver injury were excluded following extensive investigations, and the patient\u2019s liver enzymes continued to normalise following meropenem discontinuation. The patient was asymptomatic during the admission and was transferred to a rehabilitation facility. This case demonstrates that meropenem can cause severe liver injury and that early recognition of drug-induced liver injury is important.<\/jats:p>","DOI":"10.1136\/bcr-2018-227124","type":"journal-article","created":{"date-parts":[[2018,12,18]],"date-time":"2018-12-18T17:19:47Z","timestamp":1545153587000},"page":"e227124","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":14,"title":["Meropenem-induced liver injury and beta-lactam cross-reactivity"],"prefix":"10.1136","volume":"11","author":[{"given":"Timothy","family":"Tattersall","sequence":"first","affiliation":[{"name":"Infectious Diseases Unit, Queensland Health, Herston, Queensland, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hugh","family":"Wright","sequence":"additional","affiliation":[{"name":"Infectious Diseases Unit, Queensland Health, Herston, Queensland, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrew","family":"Redmond","sequence":"additional","affiliation":[{"name":"Infectious Diseases Unit, Queensland Health, Herston, Queensland, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2018,11,28]]},"reference":[{"key":"2025082801403135000_11.1.e227124.1","doi-asserted-by":"crossref","first-page":"6","DOI":"10.1111\/liv.13535","article-title":"Acute liver failure induced by idiosyncratic reaction to drugs: Challenges in diagnosis and therapy","volume":"38","author":"Tujios","year":"2018","journal-title":"Liver Int"},{"key":"2025082801403135000_11.1.e227124.2","doi-asserted-by":"crossref","first-page":"505","DOI":"10.1002\/lt.24347","article-title":"Determinants of outcome among patients with acute liver failure listed for liver transplantation in the United States","volume":"22","author":"Reddy","year":"2016","journal-title":"Liver Transpl"},{"key":"2025082801403135000_11.1.e227124.3","doi-asserted-by":"publisher","DOI":"10.1101\/cshperspect.a025247"},{"key":"2025082801403135000_11.1.e227124.4","doi-asserted-by":"publisher","DOI":"10.1128\/CMR.00007-10"},{"key":"2025082801403135000_11.1.e227124.5","doi-asserted-by":"crossref","first-page":"224","DOI":"10.3390\/ijms17020224","article-title":"Hepatotoxicity by drugs: The most common implicated agents","volume":"17","author":"Bj\u00f6rnsson","year":"2016","journal-title":"Int J Mol Sci"},{"key":"2025082801403135000_11.1.e227124.6","doi-asserted-by":"crossref","first-page":"1340","DOI":"10.1053\/j.gastro.2015.03.006","article-title":"Features and Outcomes of 899 Patients With Drug-Induced Liver Injury: The DILIN Prospective Study","volume":"148","author":"Chalasani","year":"2015","journal-title":"Gastroenterology"},{"key":"2025082801403135000_11.1.e227124.7","doi-asserted-by":"crossref","first-page":"S41","DOI":"10.1086\/590065","article-title":"Update on the efficacy and tolerability of meropenem in the treatment of serious bacterial infections","volume":"47 Suppl 1","author":"Mohr","year":"2008","journal-title":"Clin Infect Dis"},{"key":"2025082801403135000_11.1.e227124.8","doi-asserted-by":"crossref","first-page":"590","DOI":"10.1002\/hep.28323","article-title":"Categorization of drugs implicated in causing liver injury: Critical assessment based on published case reports","volume":"63","author":"Bj\u00f6rnsson","year":"2016","journal-title":"Hepatology"},{"key":"2025082801403135000_11.1.e227124.9","doi-asserted-by":"crossref","unstructured":"Estella J , Villanueva J , Calvo M , et al . 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