Severe cholestatic hepatitis following cloxacillin treatment.

Semisynthetic penicillins are widely used antibiotics. Hepatotoxicity (mainly cholestatic) associated with these drugs is a rare, but well described phenomenon.' 2 Several series of cholestatic hepatitis have been reported after treatment with flucloxacillin,2A whereas only isolated cases related to cloxacillin have been described.`'0 Cholestatic jaundice may develop up to seven weeks following cessation of treatment.3 It may present as a mild disorder or as severe, prolonged cholestatic hepatitis which may lead to a fatal outcome despite cessation of the drug.2 The optimal treatment (in addition to discontinuation of the drug) is unclear. We describe a patient who developed a severe and prolonged cholestatic hepatitis which we believe was related to cloxacillin treatment.