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- | **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 | ||
** | **50mg/kg/day IM/IV divided q6 hours | ||
**First Dose: 12. | **First Dose: 12.5mg/kg IM/IV x 1 | ||
**Max: 4 g/day | **Max: 4 g/day | ||
*Severe | *Severe | ||
** | **100mg/kg/day IM/IV divided q4-6 hours | ||
**First Dose: 16.6- | **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- | *150-200mg/kg/day divided q6-8 hours | ||
*First Dose: 37.5-66. | *First Dose: 37.5-66.6mg/kg IV x 1 | ||
*For [[MSSA]] | *For [[MSSA]] | ||
Line 41: | Line 41: | ||
*Lactation: Use caution | *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]] | ||
== | ==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
- 2g IV q4 hours + gentamicin
Prosthetic Joint Infection
- 2g IV q4 hours + rifampin
MSSA
- 2g IV q4 hours
- Examples: brain abscess, bursitis, erysipelas, mastitis, mastoiditis, osteomyelitis, perinephric abscess, pneumonia, pyomyositis, Scalded Skin Syndrome, Toxic Shock Syndrome
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
- Fever
- Rash
- Nausea and Vomiting
- Diarrhea
- Eosinophilia
- Leukopenia
- Neutropenia
- Thrombocytopenia
- Agranulocytosis
- Hepatotoxicity
- AST increased
- Acute interstitial nephritis
- Hematuria
- Serum sickness-like reactions
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]
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