Meropenem - A Potential Cause of Cholestasis in Neonates

Drug induced liver injury (DILI) is an important cause of acute and chronic liver diseases in young children. Antibiotics are known to cause drug induced liver injury, predisposing neonates to the risk of liver diseases. Meropenem is a broad-spectrum antibiotic of the carbapenem beta-lactamase group with a good spectrum of activity against gram-negative and gram-positive organisms. It is commonly used for complicated infections in neonates in intensive care units. Although a safe antibiotic, it however is known to cause mild elevation in liver enzymes, usually after 14 days of its use. We report a case of full-term neonate with sepsis developing self-limiting cholestasis with elevated liver enzymes on Day12 of meropenem therapy. This report is to create awareness about the uncommon adverse effect, cholestatic jaundice with elevation of liver enzymes, following the use of meropenem. It is important because of the widespread use of meropenem in neonates due to its safety profile and increasing resistance to commonly used antibiotics.