Which antibiotic should not be used in cases of hepatopathy?

Clindamycin is the antibiotic that should not be used in cases of hepatopathy due to its metabolic pathway and potential for liver toxicity. While clindamycin can effectively treat certain infections, it is primarily metabolized in the liver. This metabolism can be compromised when a patient has liver disease, potentially leading to increased plasma concentrations of the drug. Consequently, this may heighten the risk of adverse effects, particularly in patients with existing hepatopathy.

In contrast, the other antibiotics listed, such as enrofloxacin, doxycycline, and cefazolin, have different metabolic pathways or less association with hepatic metabolism, making them more suitable choices in the context of liver disease. Enrofloxacin is primarily excreted through the kidneys, doxycycline has a wide therapeutic range with less hepatotoxicity, and cefazolin is also primarily eliminated by the kidneys, making them less risky for use in patients with liver issues. Therefore, clindamycin is the antibiotic to avoid in cases of hepatopathy due to its risk profile related to liver function.