Antibiotic risk gene detected

Adverse reactions to the antibiotic flucloxacillin are 80 times more likely to occur in people with a particular gene, raising the possibility of a screening test being developed, researchers have said.

Flucloxacillin is estimated to cause serious liver damage in 8.5 of every 100,000 new users within 45 days of starting treatment

Researchers screened genomes from 51 people who had experienced flucloxacillin-induced liver injury. They found that the HLA-B*5701 gene was a major determinant of liver injury.

Screening for this gene could be used as the basis of a prompt diagnostic test in suspected cases of adverse reactions to flucloxacillin, so that another drug could be substituted for the antibiotic, the researchers suggest.

However, the gene variant is common in northern Europeans and only one in around 500 people carrying it will go on to develop drug-induced liver injury.

Screening for those patients who might develop drug-induced liver injury could not, therefore, be based solely on genotype, as such a test would have a very high false-positive rate, the researchers said.

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