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Cholestatic Hepatitis After Sodium Oxacillin

Charles H. McGowen, MD
JAMA. 1965;192(2):173. doi:10.1001/jama.1965.03080150103035.
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To the Editor:—  The Feb 22 issue of The Journal (191:674-675) carried an article entitled "Cholestatic Hepatitis Following the Administration of Sodium Oxacillin." I should like to suggest that the cholestatic jaundice therein described was not due to the antibiotic but rather secondary to the phenothiazine derivative used in the management of the patient's pruritus. Antibiotics and sulfonamides have been previously implicated in a number of instances, but the phenothiazines are much more notorious for their hepatotoxic properties.The patient had received an enormous amount of sodium oxacillin. In spite of this fact her liver function tests were normal. Only after the administration of trimeprazine tartrate did the patient begin to manifest both clinical and laboratory evidence of hepatitis. The first evidence of jaundice came 11 days after the institution of trimeprazine, which is certainly ample time for the cholestatis to develop. On this basis then, it is my


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