Oxacillin and the Liver

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To the editor: In a recent article (1) hepatitis from intravenous oxacillin therapy was reported in eight patients. When we received that issue of the Annals we were treating a 62-year-old woman for Staphylococcus aureus endocarditis with intravenous oxacillin and gentamicin. Symptoms of nausea, malaise, and anorexia with hepatic enlargement and tenderness began after 4 days of oxacillin (total dose of 60 g). After 8 days of oxacillin, the drug was discontinued. The patient was known to have hepatic congestion secondary to tricuspid insufficiency with baseline serum glutamic-oxalacetic transaminase (SGOT) levels of 60 to 100 mU/ml (normal, 5 to 40

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