Higher occurrence of hepatotoxicity and rash in patients treated with oxacillin, compared with those treated with nafcillin and other commonly used antimicrobials

This study compared adverse drug reactions (ADRs) to oxacillin with those t o nafcillin and other antibiotics. We reviewed the medical records of 222 c hildren receiving outpatient parenteral antimicrobial therapy (OPAT) from F ebruary 1995 through June 1999. The diagnosis, antibiotics used, ADRs, acti on taken, and patient demographics were recorded. The most common ADRs were neutropenia (9.8%), rash (8.5%), and hepatotoxicity (3.8%). ADRs occurred more frequently in the oxacillin group (58.5%) than in the nafcillin group (29.3%; P = .004), the clindamycin group (12.5%; P < .001) and the "other" antibiotics group (14.4%; P < .001). Hepatotoxicity and rash occurred more frequently in the oxacillin group (22% and 31.7%, respectively) than in the nafcillin group (0% [P < .001] and 10.3% [P = .008]), the clindamycin grou p (1.4% [P < .001] and 8.3% [P = .001]), and the other antibiotics group (1 .4% [P < .001] and 1.4% [P < .001]). On the basis of this retrospective ana lysis, oxacillin use in children was associated with a higher incidence of hepatotoxicity and rash, compared with the use of nafcillin and other intra venous antimicrobials.