Difference between revisions of "Oxacillin"

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==General==
 
==General==
 
*Type: Anti-Staphylococcal [[Penicillin]]
 
*Type: Anti-Staphylococcal [[Penicillin]]
−
*Dosage Forms:
+
*Dosage Forms: IM; IV
−
*Common Trade Names:
+
*Common Trade Names: Bactocill
  
 
==Adult Dosing==
 
==Adult Dosing==
 
===General===
 
===General===
 
*Mild-to-moderate infection
 
*Mild-to-moderate infection
−
**250-500 mg IM/IV q4-6 hours  
+
**250-500mg IM/IV q4-6 hours  
 
*Severe infection
 
*Severe infection
 
**1g IM/IV q4-6 hours  
 
**1g IM/IV q4-6 hours  
Line 23: Line 23:
 
==Pediatric Dosing==
 
==Pediatric Dosing==
 
===General===
 
===General===
−
*Mild-to-moderate infection
+
*Mild-to-moderate
−
**50 mg/kg/day IM/IV divided q6 hours  
+
**50mg/kg/day IM/IV divided q6 hours  
−
**First Dose: 12.5 mg/kg IM/IV x 1
+
**First Dose: 12.5mg/kg IM/IV x 1
 
**Max: 4 g/day  
 
**Max: 4 g/day  
−
*Severe infection
+
*Severe
−
**100 mg/kg/day IM/IV divided q4-6 hours
+
**100mg/kg/day IM/IV divided q4-6 hours
−
**First Dose: 16.6-25 mg/kg IM/IV x 1
+
**First Dose: 16.6-25mg/kg IM/IV x 1
 
**Max: 12 g/day
 
**Max: 12 g/day
  
 
===Community-Acquired [[Pneumonia]] (>3 Months)<ref>IDSA/PIDS, 2011</ref>===
 
===Community-Acquired [[Pneumonia]] (>3 Months)<ref>IDSA/PIDS, 2011</ref>===
−
*150-200 mg/kg/day divided q6-8 hours
+
*150-200mg/kg/day divided q6-8 hours
−
*First Dose: 37.5-66.6 mg/kg IV x 1
+
*First Dose: 37.5-66.6mg/kg IV x 1
 
*For [[MSSA]]
 
*For [[MSSA]]
  
 
==Special Populations==
 
==Special Populations==
−
*[[Drug Ratings in Pregnancy|Pregnancy Rating]]:
+
*[[Drug Ratings in Pregnancy|Pregnancy Rating]]: B
−
*Lactation:
+
*Lactation: Use caution
 
*Renal Dosing
 
*Renal Dosing
−
**Adult
+
**Adult: No adjustment
−
**Pediatric
+
**Pediatric:
 +
***CrCl <10: Use lower end of dosing range
 
*Hepatic Dosing
 
*Hepatic Dosing
−
**Adult
+
**Adult: Not defined
−
**Pediatric
+
**Pediatric: Not defined
  
 
==Contraindications==
 
==Contraindications==
 
*Allergy to class/drug
 
*Allergy to class/drug
 +
*Caution:
 +
**Non-anaphylactic hypersensitivity to beta-lactams
 +
**Hypersensitivity to corn
 +
**[[Asthma]]
 +
**Recent abx-associated colitis
 +
**Renal impairment
 +
**Sodium restriction
 +
**Seizure disorder
  
 
==Adverse Reactions==
 
==Adverse Reactions==
 
===Serious===
 
===Serious===
 +
*[[Fever]]
 +
*[[Rash]]
 +
*[[Nausea and Vomiting]]
 +
*[[Diarrhea]]
 +
*Eosinophilia
 +
*Leukopenia
 +
*[[Neutropenia]]
 +
*[[Thrombocytopenia]]
 +
*Agranulocytosis
 +
*Hepatotoxicity
 +
*AST increased
 +
*Acute interstitial nephritis
 +
*Hematuria
 +
*Serum sickness-like reactions
  
 
===Common===
 
===Common===
  
 
==Pharmacology==
 
==Pharmacology==
−
*Half-life:  
+
*Half-life: 20-60 minutes (prolonged in neonates and renal impairment)
−
*Metabolism:  
+
*Metabolism: Liver 45%; active metabolite
−
*Excretion:  
+
*Excretion: Urine (55-60% unchanged), Bile 10%
−
*Mechanism of Action:
+
*Mechanism of Action: Bactericidal; inhibits cell wall mucopeptide synthesis
 +
 
 +
==[[Antibiotic Sensitivities]]<ref>Sanford Guide to Antimicrobial Therapy 2014</ref>==
 +
{| class="wikitable"
 +
| align="center" style="background:#f0f0f0;"|'''Group'''
 +
| align="center" style="background:#f0f0f0;"|'''Organism'''
 +
| align="center" style="background:#f0f0f0;"|'''Sensitivity'''
 +
|-
 +
| Gram Positive||[[Strep. Group A, B, C, G]]||'''S'''
 +
|-
 +
| ||[[Strep. Pneumoniae]]||'''S'''
 +
|-
 +
| ||[[Viridans strep]]||I
 +
|-
 +
| ||Strep. anginosus gp||'''S'''
 +
|-
 +
| ||[[Enterococcus faecalis]]||R
 +
|-
 +
| ||[[Enterococcus faecium]]||R
 +
|-
 +
| ||[[MSSA]]||'''S'''
 +
|-
 +
| ||[[MRSA]]||R
 +
|-
 +
| ||[[CA-MRSA]]||R
 +
|-
 +
| ||[[Staph. Epidermidis]]||'''S'''
 +
|-
 +
| ||[[C. jeikeium]]||R
 +
|-
 +
| ||[[L. monocytogenes]]||R
 +
|-
 +
| Gram Negatives||[[N. gonorrhoeae]]||R
 +
|-
 +
| ||[[N. meningitidis]]||R
 +
|-
 +
| ||[[Moraxella catarrhalis]]||R
 +
|-
 +
| ||[[H. influenzae]]||R
 +
|-
 +
| ||[[E. coli]]||R
 +
|-
 +
| ||[[Klebsiella]] sp||R
 +
|-
 +
| ||E. coli/Klebsiella ESBL+||R
 +
|-
 +
| ||E coli/Klebsiella KPC+||R
 +
|-
 +
| ||[[Enterobacter]] sp, AmpC neg||R
 +
|-
 +
| ||[[Enterobacter]] sp, AmpC pos||R
 +
|-
 +
| ||[[Serratia]] sp||R
 +
|-
 +
| ||Serratia marcescens||X1
 +
|-
 +
| ||[[Salmonella]] sp||R
 +
|-
 +
| ||[[Shigella]] sp||R
 +
|-
 +
| ||[[Proteus mirabilis]]||R
 +
|-
 +
| ||[[Proteus vulgaris]]||R
 +
|-
 +
| ||[[Providencia sp.]]||R
 +
|-
 +
| ||[[Morganella sp.]]||R
 +
|-
 +
| ||[[Citrobacter freundii]]||R
 +
|-
 +
| ||[[Citrobacter diversus]]||R
 +
|-
 +
| ||[[Citrobacter sp.]]||R
 +
|-
 +
| ||[[Aeromonas sp]]||R
 +
|-
 +
| ||[[Acinetobacter sp.]]||R
 +
|-
 +
| ||[[Pseudomonas aeruginosa]]||R
 +
|-
 +
| ||[[Burkholderia cepacia]]||R
 +
|-
 +
| ||[[Stenotrophomonas maltophilia]]||R
 +
|-
 +
| ||[[Yersinia enterocolitica]]||R
 +
|-
 +
| ||[[Francisella tularensis]]||X1
 +
|-
 +
| ||[[Brucella sp.]]||X1
 +
|-
 +
| ||[[Legionella sp.]]||R
 +
|-
 +
| ||[[Pasteurella multocida]]||R
 +
|-
 +
| ||[[Haemophilus ducreyi]]||X1
 +
|-
 +
| ||[[Vibrio vulnificus]]||X1
 +
|-
 +
| Misc||[[Chlamydophila sp]]||R
 +
|-
 +
| ||[[Mycoplasm pneumoniae]]||R
 +
|-
 +
| ||[[Rickettsia sp]]||X1
 +
|-
 +
| ||[[Mycobacterium avium]]||X1
 +
|-
 +
| Anaerobes||[[Actinomyces]]||R
 +
|-
 +
| ||[[Bacteroides fragilis]]||R
 +
|-
 +
| ||[[Prevotella melaninogenica]]||R
 +
|-
 +
| ||[[Clostridium difficile]]||X1
 +
|-
 +
| ||[[Clostridium (not difficile)]]||X1
 +
|-
 +
| ||[[Fusobacterium necrophorum]]||X1
 +
|-
 +
| ||[[Peptostreptococcus sp.]]||'''S'''
 +
|}
 +
 
 +
===Key===
 +
{{Template:Antibacterial Spectra Key}}
  
 
==See Also==
 
==See Also==
 
*[[Antibiotics]]
 
*[[Antibiotics]]
  
−
==Source==
+
==References==
 +
<references/>
  
−
<references/>
+
[[Category:Pharmacology]]
 +
[[Category:ID]]

Latest revision as of 00:48, 23 September 2019

General

  • Type: Anti-Staphylococcal Penicillin
  • Dosage Forms: IM; IV
  • Common Trade Names: Bactocill

Adult Dosing

General

  • Mild-to-moderate infection
    • 250-500mg IM/IV q4-6 hours
  • Severe infection
    • 1g IM/IV q4-6 hours

Endocarditis

Prosthetic Joint Infection

MSSA

Pediatric Dosing

General

  • Mild-to-moderate
    • 50mg/kg/day IM/IV divided q6 hours
    • First Dose: 12.5mg/kg IM/IV x 1
    • Max: 4 g/day
  • Severe
    • 100mg/kg/day IM/IV divided q4-6 hours
    • First Dose: 16.6-25mg/kg IM/IV x 1
    • Max: 12 g/day

Community-Acquired Pneumonia (>3 Months)[1]

  • 150-200mg/kg/day divided q6-8 hours
  • First Dose: 37.5-66.6mg/kg IV x 1
  • For MSSA

Special Populations

  • Pregnancy Rating: B
  • Lactation: Use caution
  • Renal Dosing
    • Adult: No adjustment
    • Pediatric:
      • CrCl <10: Use lower end of dosing range
  • Hepatic Dosing
    • Adult: Not defined
    • Pediatric: Not defined

Contraindications

  • Allergy to class/drug
  • Caution:
    • Non-anaphylactic hypersensitivity to beta-lactams
    • Hypersensitivity to corn
    • Asthma
    • Recent abx-associated colitis
    • Renal impairment
    • Sodium restriction
    • Seizure disorder

Adverse Reactions

Serious

Common

Pharmacology

  • Half-life: 20-60 minutes (prolonged in neonates and renal impairment)
  • Metabolism: Liver 45%; active metabolite
  • Excretion: Urine (55-60% unchanged), Bile 10%
  • Mechanism of Action: Bactericidal; inhibits cell wall mucopeptide synthesis

Antibiotic Sensitivities[2]

Group Organism Sensitivity
Gram Positive Strep. Group A, B, C, G S
Strep. Pneumoniae S
Viridans strep I
Strep. anginosus gp S
Enterococcus faecalis R
Enterococcus faecium R
MSSA S
MRSA R
CA-MRSA R
Staph. Epidermidis S
C. jeikeium R
L. monocytogenes R
Gram Negatives N. gonorrhoeae R
N. meningitidis R
Moraxella catarrhalis R
H. influenzae R
E. coli R
Klebsiella sp R
E. coli/Klebsiella ESBL+ R
E coli/Klebsiella KPC+ R
Enterobacter sp, AmpC neg R
Enterobacter sp, AmpC pos R
Serratia sp R
Serratia marcescens X1
Salmonella sp R
Shigella sp R
Proteus mirabilis R
Proteus vulgaris R
Providencia sp. R
Morganella sp. R
Citrobacter freundii R
Citrobacter diversus R
Citrobacter sp. R
Aeromonas sp R
Acinetobacter sp. R
Pseudomonas aeruginosa R
Burkholderia cepacia R
Stenotrophomonas maltophilia R
Yersinia enterocolitica R
Francisella tularensis X1
Brucella sp. X1
Legionella sp. R
Pasteurella multocida R
Haemophilus ducreyi X1
Vibrio vulnificus X1
Misc Chlamydophila sp R
Mycoplasm pneumoniae R
Rickettsia sp X1
Mycobacterium avium X1
Anaerobes Actinomyces R
Bacteroides fragilis R
Prevotella melaninogenica R
Clostridium difficile X1
Clostridium (not difficile) X1
Fusobacterium necrophorum X1
Peptostreptococcus sp. S

Key

  • S susceptible/sensitive (usually)
  • I intermediate (variably susceptible/resistant)
  • R resistant (or not effective clinically)
  • S+ synergistic with cell wall antibiotics
  • U sensitive for UTI only (non systemic infection)
  • X1 no data
  • X2 active in vitro, but not used clinically
  • X3 active in vitro, but not clinically effective for Group A strep pharyngitis or infections due to E. faecalis
  • X4 active in vitro, but not clinically effective for strep pneumonia

See Also

References

  1. ↑ IDSA/PIDS, 2011
  2. ↑ Sanford Guide to Antimicrobial Therapy 2014
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