Oxacillin


Full Prescribing Info
Dosage/Direction for Use

Oral
Infections due to staphylococci resistant to benzylpenicillin
Adult: 1 g bid.

Parenteral
Infections due to staphylococci resistant to benzylpenicillin
Adult: 250-500 mg 4-6 hrly, by IM, slow IV inj over 10 min or IV infusion. May increase to 1 g 4-6 hrly for severe infections.
Child: <40 kg: 50-100 mg/kg/day IV, in divided doses. Premature and neonates: 25 mg/kg/day IV.
Reconstitution:
IM: Add 5.7 mL or 11.4 mL of sterile water for inj to the vial containing 1 g or 2 g of oxacillin, respectively, to provide soln containing 167 mg/mL (250 mg/1.5 mL). IV: Add 10 mL or 20 mL of sterile water for inj or NaCl 0.45% or 0.9% inj to the vial containing 1 g or 2 g of oxacillin, respectively. For IV infusion, dilute further w/ a compatible IV soln to a concentration of 0.5-40 mg/mL.
Incompatibility: Caffeine citrate, Na bicarbonate, verapamil. Variable: Doxapram, vit B complex w/ vit C.
Contraindications
Hypersensitivity to oxacillin and other penicillins.
Special Precautions
Patient w/ history of history of asthma, β-lactam allergy. Pregnancy and lactation. Monitoring Parameters Monitor blood cultures, WBC, differential cell counts, urinalysis, BUN, serum creatinine, AST and ALT values. Observe for signs and symptoms of anaphylaxis during 1st dose.
Adverse Reactions
Fever, rash, nausea, diarrhoea, vomiting, eosinophilia, leucopenia, neutropenia, thrombocytopenia, agranulocytosis, hepatotoxicity, increased AST, acute interstitial nephritis, haematuria, serum sickness-like reactions.
Potentially Fatal: Anaphylactic shock w/ collapse, Clostridium difficile-associated diarrhoea (CDAD).
Overdosage
Symptoms: Neuromuscular hypersensitivity (e.g. agitation, hallucinations, asterixis, encephalopathy, confusion, and seizures), electrolyte imbalance (if the preparation contains K or Na salts, esp in renal failure). Management: Symptomatic and supportive treatment.
Drug Interactions
Tetracycline may antagonise the bactericidal effect of oxacillin. Enhanced plasma concentrations by probenecid.
Lab Interference
May interfere w/ urinary glucose tests using cupric sulfate (Benedict's soln). False-positive urinary and serum proteins.
Action
Oxacillin inhibits bacterial cell wall synthesis by binding to 1 or more of the penicillin-binding proteins (PBPs) which in turn inhibit the final transpeptidation step of peptidoglycan synthesis in bacterial cell walls. Bacteria eventually lyse due to ongoing activity of cell wall autolytic enzymes (autolysins and murein hydrolases) while cell wall assembly is arrested.
Absorption: Incompletely absorbed from the GI tract. Absorption is reduced by the presence of food. Time to peak plasma concentration: 1 hr (oral); 30 min (IM).
Distribution: Distributed into synovial, pleural pericardial and ascitic fluids; bone, lungs, sputum and bile; cord serum and amniotic fluid. Crosses the placenta and enters breast milk. Volume of distribution: 0.39-0.43 L/kg. Plasma protein binding: Approx 93%.
Metabolism: Partially metabolised to active and inactive metabolites in the liver.
Excretion: Via urine (oral: approx 20-30%; IM: >40%) as unchanged drug and metabolites and bile. Plasma half-life: Approx 30 min.
Storage
Oral: Store between 20-25°C. Parenteral: Store between 20-25°C.
CIMS Class
ATC Classification
J01CF04 - oxacillin ; Belongs to the class of beta-lactamase resistant penicillins. Used in the systemic treatment of infections.
Disclaimer: This information is independently developed by CIMS based on oxacillin from various references and is provided for your reference only. Therapeutic uses, prescribing information and product availability may vary between countries. Please refer to CIMS Product Monographs for specific and locally approved prescribing information. Although great effort has been made to ensure content accuracy, CIMS shall not be held responsible or liable for any claims or damages arising from the use or misuse of the information contained herein, its contents or omissions, or otherwise. Copyright © 2020 CIMS. All rights reserved. Powered by CIMSAsia.com
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