Hepatitis from Intravenous High-Dose Oxacillin Therapy

A retrospective review of all patients who received oxacillin intravenously in doses greater than 6 g/day was done. Eight patients in whom oxacillin-associated hepatitis developed were found and compared with a control group of 46 patients who had received high-dose oxacillin and in whom oxacillin-associated hepatitis did not develop. The latent period to development of typical symptoms of hepatitis varied from 2 to 21 days. Laboratory abnormalities were compatible with anicteric hepatitis and reverted to normal after withdrawal of the drug. Oxacillin hepatitis most like represents a hypersensitivity reaction. We recommend that routine liver chemistries be done regularly in all patients receiving high-dose intravenous oxacillin.