title: Oxacillin-induced tissue necrosis.
abstract: OBJECTIVE
  To report a case of oxacillin-induced tissue necrosis in which recommended concentration guidelines for dilution and administration were used. Oxacillin concentration data, potential risk factors, and treatment options for extravasation injuries are also briefly reviewed.
  
  
  METHODS
  Oxacillin was infused peripherally by infusion pump in a 79-year-old white woman as prophylactic antibiotic coverage for permanent pacemaker placement. Oxacillin extravasation occurred after the second postoperative dose. A dime-sized area of necrosis was noted at the heparin-lock insertion site.
  
  
  CONCLUSIONS
  Only one case of oxacillin-induced necrosis has been reported. The degree of damage and concentration of drug used were not specifically described. Concentration may play a role in the appearance or absence of tissue damage after an antibiotic extravasation and should be taken into consideration when evaluating a drug's tissue toxicity potential.
  
  
  CONCLUSIONS
  The potential exists for oxacillin 50 mg/mL to cause tissue damage in humans if an extravasation occurs. This reaction may be avoided with use of a less-concentrated preparation, avoidance of infusion pump administration, and identification of high-risk patients.
authors.affiliation: Department of Pharmacy, St. Vincent Hospital, Worcester, MA 01604, USA.
authors.forename: L A
authors.initials: LA
authors.lastname: Fromm
authors.forename: D L
authors.initials: DL
authors.lastname: Graham
mesh_terms: D000368:Aged; D019072:Antibiotic Prophylaxis; D004890:Erythema / Q000209:etiology* / Q000473:pathology; D005119:Extravasation of Diagnostic and Therapeutic Materials / Q000150:complications; D005260:Female; D006801:Humans; D007262:Infusions, Intravenous; D009336:Necrosis; D010068:Oxacillin / Q000009:adverse effects* / Q000627:therapeutic use; D010406:Penicillins / Q000009:adverse effects* / Q000627:therapeutic use
chemical_list: D010406:Penicillins; D010068:Oxacillin