Difference between revisions of "Oxacillin"
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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: 12.5mg/kg IM/IV x 1 | **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: 16.6-25mg/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- | + | *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 71: | Line 80: | ||
==Pharmacology== | ==Pharmacology== | ||
*Half-life: 20-60 minutes (prolonged in neonates and renal impairment) | *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>== | ==[[Antibiotic Sensitivities]]<ref>Sanford Guide to Antimicrobial Therapy 2014</ref>== | ||
| Line 200: | Line 209: | ||
*[[Antibiotics]] | *[[Antibiotics]] | ||
| − | == | + | ==References== |
| − | |||
<references/> | <references/> | ||
| + | [[Category:Pharmacology]] | ||
[[Category:ID]] | [[Category:ID]] | ||
Latest revision as of 00:48, 23 September 2019
Contents
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