Faculty Bibliography

A prospective survey of liver function during oxacillin sodium therapy revealed five cases of drug-related abnormalities among 41 patients. In each instance, the serum transaminase level was increased from normal to greater than 100 units. The serum alkaline phosphatase level was mildly elevated and bilirubin levels remained normal. All of the patients were asymptomatic. Hepatic dysfunction was reversible on withdrawal of oxacillin therapy and substitution of a cephalosporin or clindamycin. The observed abnormalities in liver function were associated with a daily oxacillin sodium dose of greater than or equal to 12 gm as well as with heroin addiction and staphylococcal endocarditis

BA and OA of sera and uninfected ascitic fluid from patients with alcoholic cirrhosis were assayed against gram-negative enteric bacilli. This was compared with BA and OA in normal serum and in peritoneal fluid obtained at laparoscopy or laparotomy from noncirrhotic patients. Cirrhotic sera showed significantly reduced BA and OA against one of the organisms tested, Serratia marcescens. It had reduced OA but normal BA against E. coli. Ascitic fluid was markedly deficient in BA and OA against all strains tested when compared to both cirrhotic sera and nonascitic peritoneal fluid. Immunoglobulin and complement concentrations in cirrhotic ascites were reduced. Ascites did not inhibit the BA or OA of normal serum. However, replacement experiments suggested that the diminished activity of ascites was largely the result of its reduced complement concentration. The demonstrated deficit in both BA and OA of ascites may be a factor in the frequency of spontaneous enteric bacillary peritonitis in the cirrhotic patient