Oxacillin: Difference between revisions
 
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*Type: Anti-Staphylococcal [[Penicillin]]
*Type: Anti-Staphylococcal [[Penicillin]]
*Dosage Forms: IM; IV
*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 24: Line 24:
===General===
===General===
*Mild-to-moderate
*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
*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]]: B
*[[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==
Line 70: Line 79:


==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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