We report the case of a possible hepatotoxic reaction in a patient receiving the investigational macrolide antibiotic, rosaramicin. The patient presented with complaints attributable to an acute cholestatic reaction with a maculopapular skin rash. Serum enzymes indicative of hepatic function were initially markedly elevated but returned to normal after withdrawal of the drug. Because of the close chemical structural similarity of rosaramicin to other macrolide antibiotics known to produce similar hepatotoxic reactions, careful surveillance of patients receiving this drug is suggested.
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