Hepatitis associated with high-dose oxacillin therapy.

A prospective survey of liver function during oxacillin sodium therapy revealed five cases of drug-related abnormalities among 41 patients. In each instance, the serum transaminase level was increased from normal to greater than 100 units. The serum alkaline phosphatase level was mildly elevated and bilirubin levels remained normal. All of the patients were asymptomatic. Hepatic dysfunction was reversible on withdrawal of oxacillin therapy and substitution of a cephalosporin or clindamycin. The observed abnormalities in liver function were associated with a daily oxacillin sodium dose of greater than or equal to 12 gm as well as with heroin addiction and staphylococcal endocarditis.