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oxacillin (Rx)Brand and Other Names:Bactocill

 
 
 

Dosing & Uses

AdultPediatric

Dosage Forms & Strengths

infusion solution

  • 1g/50mL
  • 2g/50mL

powder for injection

  • 1g
  • 2g
  • 10g
more...

Staphylococcal Infections

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

Renal Infection

CrCl < 10 mL/min: May consider adjusting to the lower range of the usually recommended dose depending on severity of infection

Dosage Forms & Strengths

infusion solution

  • 1g/50mL
  • 2g/50mL

powder for injection

  • 1g
  • 2g
  • 10g
more...

Susceptible Staph Infections in Infants & Children

Mild to moderate infections: 100-200 mg/kg/day IV/IM divided q6hr  

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

Susceptible Staph Infections in Neonates

(<7 days old, <2 kg) OR (>7 days old, <1.2 kg): 50 mg/kg/day divided q12hr IV/IM 

(<7 days old, >2 kg) OR (>7 days old, 1.2-2 kg): 75 mg/kg/day divided q8hr IV/IM

>7 days old, >2 kg: 100 mg/kg/day divided q6hr IV/IM

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Interactions

Interaction Checker

oxacillin and

No Results

     
     activity indicator 
    No Interactions Found
    Interactions Found

    Contraindicated

      Serious - Use Alternative

        Significant - Monitor Closely

          Minor

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            Adverse Effects

            1-10%

            Diarrhea

            Nausea

            Fever

            Rash

            <1%

            Eosinophilia

            Leukopenia

            Neutropenia

            Thrombocytopenia

            Hepatotoxicity

            Elevated AST

            Acute interstitial nephritis

            Serum sickness-like reaction

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            Warnings

            Contraindications

            Allergy to penicillins, cephalosporins, imipenem

            Solutions containing dextrose may be contraindicated in patients with known allergy to corn or corn products

            Cautions

            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

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            Pregnancy & Lactation

            Pregnancy Category: B

            Lactation: excreted in breast milk; use caution

            Pregnancy Categories

            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.

            more...
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            Pharmacology

            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.

            Pharmacokinetics

            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

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            Administration

            IV Incompatibilities

            Additive: amikacin(?), cytarabine

            Syringe: caffeine

            Y-site: Na bicarb, verapamil

            Aminoglycosides & tetracyclines, but compatibility depends on several factors (eg, concentrations of the drugs, specific diluents used, resulting pH, temperature)

            IV Compatibilities

            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

            IV/IM Preparation

            IM Injection

            • 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

            IV Injection

            • 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

            IV/IM Administration

            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

            Storage

            Oxacillin powder: store at controlled room temp

            Oxacillin in dextrose injection: store <-20°C

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            Formulary

            FormularyPatient Discounts

            To view formulary information first create a list of plans. Your list will be saved and can be edited at any time.

            Adding plans allows you to:

            • View the formulary and any restrictions for each plan.
            • Manage and view all your plans together – even plans in different states.
            • Compare formulary status to other drugs in the same class.
            • Access your plan list on any device – mobile or desktop.

            The above information is provided for general informational and educational purposes only. Individual plans may vary and formulary information changes. Contact the applicable plan provider for the most current information.

            Tier Description
            1 This drug is available at the lowest co-pay. Most commonly, these are generic drugs.
            2 This drug is available at a middle level co-pay. Most commonly, these are "preferred" (on formulary) brand drugs.
            3 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs.
            4 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
            5 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
            6 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
            NC NOT COVERED – Drugs that are not covered by the plan.
            Code Definition
            PA Prior Authorization
            Drugs that require prior authorization. This restriction requires that specific clinical criteria be met prior to the approval of the prescription.
            QL Quantity Limits
            Drugs that have quantity limits associated with each prescription. This restriction typically limits the quantity of the drug that will be covered.
            ST Step Therapy
            Drugs that have step therapy associated with each prescription. This restriction typically requires that certain criteria be met prior to approval for the prescription.
            OR Other Restrictions
            Drugs that have restrictions other than prior authorization, quantity limits, and step therapy associated with each prescription.
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