{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,4]],"date-time":"2026-06-04T16:23:03Z","timestamp":1780590183271,"version":"3.54.1"},"reference-count":27,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2005,3,2]],"date-time":"2005-03-02T00:00:00Z","timestamp":1109721600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Brit J Clinical Pharma"],"published-print":{"date-parts":[[2005,7]]},"abstract":"<jats:sec><jats:title>Aims<\/jats:title><jats:p>To provide additional quantification of the risk of flucloxacillin\u2010related liver disease and to describe time trends in flucloxacillin prescribing in the UK.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This was a cohort study using data from the UK General Practice Research Database. We identified patients with a first\u2010time prescription for flucloxacillin or, for comparison, oxytetracycline from 1992 to 2002 and cases who developed clinically documented cholestatic liver disease of uncertain origin after first\u2010time use of these drugs. We also determined the annual frequency of first\u2010time use of flucloxacillin from 1991 to 2000.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>We identified 283\u2003097 and 131\u2003189 first\u2010time users of flucloxacillin and oxytetracycline, respectively. The risk of cholestatic liver disease per 100 000 first\u2010time users was 8.5 (95% CI 5.4, 12.6) in the 1\u201345\u2003days and 1.8 (95% CI 0.6, 4.1) in the 46\u201390\u2003days after starting flucloxacillin, and 0.8 (95% CI 0.02, 4.3) in the 1\u201345\u2003days after starting oxytetracycline. The frequency of first\u2010time use of flucloxacillin remained stable between 1991 and 2000.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Flucloxacillin is now established as an important cause of cholestatic liver disease. Warnings about the risk have not had an impact on prescribing practices in the UK, where it remains the predominantly prescribed antistaphylococcal oral antibiotic. This situation in the UK is in sharp contrast to regulatory actions and changes in prescribing habits in Australia after identification of the risk of cholestasis associated with flucloxacillin, and to the predominant use of the alternative drug dicloxacillin in the USA.<\/jats:p><\/jats:sec>","DOI":"10.1111\/j.1365-2125.2005.02370.x","type":"journal-article","created":{"date-parts":[[2005,6,20]],"date-time":"2005-06-20T12:38:34Z","timestamp":1119271114000},"page":"76-82","source":"Crossref","is-referenced-by-count":99,"title":["Risk of cholestatic liver disease associated with flucloxacillin and flucloxacillin prescribing habits in the UK: Cohort study using data from the UK General Practice Research Database"],"prefix":"10.1111","volume":"60","author":[{"given":"Stefan","family":"Russmann","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"James A.","family":"Kaye","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Susan S.","family":"Jick","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hershel","family":"Jick","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2005,3,2]]},"reference":[{"key":"e_1_2_6_2_2","first-page":":","article-title":"Flucloxacillin hepatitis","volume":"9","author":"Australian Adverse Drug Reactions Advisory Committee (ADRAC).","year":"1990","journal-title":"Australian Adverse Drug Reactions Bulletin"},{"key":"e_1_2_6_3_2","doi-asserted-by":"publisher","DOI":"10.3109\/00365548509070433"},{"key":"e_1_2_6_4_2","first-page":"483","article-title":"Cholestatic jaundice due to derivatives of oxacillin","volume":"82","author":"Deboever G","year":"1987","journal-title":"Am J Gastroenterol"},{"key":"e_1_2_6_5_2","first-page":"81","article-title":"Flucloxacillin associated cholestatic hepatitis. 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