Background: Cefixime is widely used in treating infections in children, and it can commonly cause minor gastrointestinal adverse effects. However, hepatotoxicity and acute renal failure are among the rarely reported serious adverse drug reactions of cefixime and other cephalosporins. Case Presentation: We report the case of a 7-month-old infant who was previously well but was admitted to the pediatric intensive care unit as she developed acute onset hepatic and renal failure two days after cefixime treatment. Her liver enzymes were more than 5-times the upper normal limit and her kidney function deteriorated acutely and rapidly over a short period, with evident acute renal parenchymal disease on abdominal ultrasound. Conclusion: Given the nature of rapid resolution of all organ-related insults and no other confirmed diagnosis and with the support of Naranjo and Roussel Uclaf Causality Assessment Method scales, this is probably the first case of cefixime-induced hepatotoxicity and acute renal failure.

Keywords: cephalosporin, hepatotoxicity, renal failure, case report