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Hepatitis associated with high-dose oxacillin therapy.

A A Pollock, S A Berger, M S Simberkoff

    Archives of Internal Medicine
    |June 1, 1978
    PubMed
    Summary
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    Oxacillin sodium therapy can cause liver abnormalities, including elevated transaminase levels, in some patients. These drug-related liver issues were reversible upon discontinuing oxacillin.

    Area of Science:

    • Pharmacology
    • Hepatology
    • Infectious Diseases

    Background:

    • Oxacillin sodium is an antibiotic commonly used to treat bacterial infections.
    • Liver function abnormalities are potential adverse effects of various medications.

    Purpose of the Study:

    • To investigate the incidence and characteristics of liver function abnormalities associated with oxacillin sodium therapy.
    • To identify risk factors for drug-related hepatic dysfunction during oxacillin treatment.

    Main Methods:

    • A prospective survey was conducted on 41 patients receiving oxacillin sodium.
    • Liver function tests, including serum transaminases, alkaline phosphatase, and bilirubin, were monitored.

    Main Results:

    • Five out of 41 patients (12.2%) developed drug-related liver abnormalities.

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  • Abnormalities included elevated serum transaminases (>100 units) with mild alkaline phosphatase increases; bilirubin remained normal.
  • Asymptomatic hepatic dysfunction was reversible upon oxacillin withdrawal and antibiotic substitution (cephalosporin or clindamycin).
  • Risk factors identified included high-dose oxacillin sodium (≥12 gm/day), heroin addiction, and staphylococcal endocarditis.
  • Conclusions:

    • Oxacillin sodium can induce asymptomatic, reversible liver function abnormalities in a subset of patients.
    • High-dose oxacillin, heroin addiction, and staphylococcal endocarditis are associated with increased risk.
    • Monitoring liver function is advisable in patients receiving high-dose oxacillin, particularly those with risk factors.