Brand and Other Names:Bactocill
- Classes: Penicillins, Penicillinase-Resistant
Dosing & Uses
Dosage Forms & Strengths
powder for injection
Mild to moderate infections: 250-500 mg IV/IM q4-6hr
Severe infections: 1 g IV/IM q4-6hr
Acute/chronic osteomyelitis/staphylococci infections: 1.5-2 g IV q4-6hr
CrCl < 10 mL/min: May consider adjusting to the lower range of the usually recommended dose depending on severity of infection
Dosage Forms & Strengths
powder for injection
Susceptible Staph Infections in Infants & Children
Severe infections: 150-200 mg/kg/day IV/IM divided q6hr
Maximum 4g/day for mild to moderate infections
Maximum 12g/day for severe infections
Serious - Use Alternative
Significant - Monitor Closely
Acute interstitial nephritis
Serum sickness-like reaction
Allergy to penicillins, cephalosporins, imipenem
Solutions containing dextrose may be contraindicated in patients with known allergy to corn or corn products
Evaluate renal, hepatic, hematologic systems periodically during prolonged treatment
Monitor neonates for renal impairment
Monitor organ systems/serum concentrations of drug in neonates
Prolonged treatment may result in bacterial or fungal superinfection
Clostridium difficile associated diarrhea (CDAD) must be considered in all patients who present with diarrhea following antibiotic; CDAD has been reported to occur over two months after the administration of antibacterial agents; careful medical history is necessary; if CDAD suspected or confirmed, ongoing antibiotic use not directed against C. difficile may need to be discontinued; appropriate fluid and electrolyte management, protein supplementation, antibiotic treatment of C. difficile, and surgical evaluation should be instituted as indicated
Pregnancy & Lactation
Pregnancy Category: B
Lactation: excreted in breast milk; use caution
A:Generally acceptable. Controlled studies in pregnant women show no evidence of fetal risk.
B:May be acceptable. Either animal studies show no risk but human studies not available or animal studies showed minor risks and human studies done and showed no risk.
C:Use with caution if benefits outweigh risks. Animal studies show risk and human studies not available or neither animal nor human studies done.
D:Use in LIFE-THREATENING emergencies when no safer drug available. Positive evidence of human fetal risk.
X:Do not use in pregnancy. Risks involved outweigh potential benefits. Safer alternatives exist.
NA:Information not available.
Mechanism of Action
Bactericidal antibiotic that inhibits cell wall synthesis by binding to one or more of the penicillin binding proteins. Used in the treatment of infections caused by penicillinase-producing staphylococci. May be used to initiate therapy when a staphylococcal infection is suspected.
Half-Life: 23-60 min (adults; prolonged in renal insufficiency); 0.9-1.8 hr (children)
Peak Plasma Time: 30-60 min
Protein binding: 94%
Distribution: Bile, synovial, pleural, peritoneal, pericardial fluids
Metabolism: Hepatic to active metabolites
Excretion: Urine and feces
Additive: amikacin(?), cytarabine
Y-site: Na bicarb, verapamil
Aminoglycosides & tetracyclines, but compatibility depends on several factors (eg, concentrations of the drugs, specific diluents used, resulting pH, temperature)
Solution: compatible w/ most common solvents
Additive: Chloramphenicol Na succinate, dopamine, KCl, verapamil
Y-site (partial list): Acyclovir, diltiazem, fluconazole, heparin, hydromorphone, MgSO4, meperidine, morphine, KCl, vit B/C, zidovudine
- For IM injection, reconstitute by adding 5.7 or 11.4 mL of SWI to a vial containing 1 or 2 g of oxacillin, respectively, to provide solutions containing 167 mg of oxacillin per mL (250 mg/1.5 mL)
- Shake vials well
- For direct injection, prepare a solution containing approximately 100 mg/mL by adding 10 or 20 mL SWI, ½NS or NS to vials containing 1 or 2 g of oxacillin, respectively
Intermittent or Continuous IV Infusion
- For intermittent IV infusion, reconstitute vials containing 1 or 2 g as for direct IV injection & further dilute with a compatible IV solution to a concentration of 0.5-40 mg/mL
- Alternatively, reconstitute ADD-Vantage vials containing 1 or 2 g according to the mfr's directions
Administer by IM injection or slow IV injection or infusion
IM: deep into a large muscle (eg, gluteus maximus) & care should be taken to avoid sciatic nerve injury
IV Injection: slowly over about 10 min
Intermittent or Continuous IV Infusion: injections should not be used in series connections with other plastic containers: could result in air embolism from residual air being drawn from primary container before administration of fluid from secondary container is complete
Oxacillin powder: store at controlled room temp
Oxacillin in dextrose injection: store <-20°C
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