This study compared
adverse drug reactions (ADRs) to
oxacillin with those to
nafcillin and other
antibiotics. We reviewed the medical records of 222 children receiving outpatient parenteral antimicrobial
therapy (OPAT) from February 1995 through June 1999. The diagnosis,
antibiotics used, ADRs, action 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 group (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 analysis,
oxacillin use in children was associated with a higher incidence of hepatotoxicity and
rash, compared with the use of
nafcillin and other intravenous antimicrobials.