Abstract
Background:
Augmentin is a common antibiotic used to treat infections. However, it may cause liver damage. This toxicity often involves oxidative stress and inflammation. N-acetylcysteine (NAC) is known for its antioxidant and anti-inflammatory effects and may help protect the liver.

Aim:
This study aimed to assess if NAC could reduce liver and bile duct injury caused by Augmentin.

Methods:
Forty adult male rats were divided into four groups. Group 1 was the control. Group 2 received Augmentin (30 mg/kg/day). Group 3 received NAC (150 mg/kg/day). Group 4 received both received both NAC and Augmentin. Treatments lasted 35 days. Serum levels of TNF-α, MDA, GSH, and CYP7A1 were measured. Histopathology was also done.

Results:
Augmentin alone caused a significant increase in TNF-α (13.82 ± 0.31), MDA (407.25 ± 10.65), and CYP7A1 (7.69 ± 0.48). GSH dropped to (9.10 ± 0.43). Liver tissues showed inflammation, sinusoidal congestion, and bile duct damage. NAC-treated rats had lower TNF-α (4.88–4.97), MDA (253.05–258.15), and CYP7A1 (4.30–4.38). GSH levels increased to (15.58–17.02). Histology improved with NAC. Livers showed fewer cell injuries and more normal architecture.

Conclusion:
NAC reduced oxidative stress and inflammation caused by Augmentin. It also protected liver structure. These findings suggest that NAC may be a useful supplement in preventing drug-induced liver injury.

Key words: CYP7A1; Glutathione; Histopathology; Malondialdehyde; TNF-α.