Penicillin類抗生素

Treatment of infections such as osteomyelitis, septicemia, endocarditis, and CNS infections caused by susceptible strains of Staphylococcus

Oxacillin sodium is a semisynthetic, penicillinase-resistant penicillin. It exerts its bactericidal effect against actively replicating susceptible microorganisms by blocking the bacterial cell-wall synthesis. It is effective against nonpenicillinase-producing and penicillinase-producing strains of Staphylococcus aureus.

Distribution:
1. Into bile, pleural fluids; insignificant concentrations in CSF and aqueous humor
2. Protein binding: ~94% (mainly albumin)
Metabolism:
Hepatic
Time to peak, serum:
IM: 30 minutes; IV: 5 minutes
Excretion:
1. Urine and bile (unchanged drug)
2. Half-life elimination: (Neonates) 1.6 hours; (Infants and Children ≤2 years) 0.9 to 1.8 hours; (Adults) 20 to 30 minutes

Hypersensitivity to oxacillin or other penicillins

B

Enters breast milk/use caution

Rash, Diarrhea, nausea, vomiting, increased serum SGOT and SGPT

Pneumonia:
Pathogen-directed therapy for methicillin-susceptible S. aureus: (IV) 2 g Q4H for 5 (community-acquired pneumonia) to 7 days (hospital-acquired or ventilator-associated pneumonia)
Prosthetic joint infection:
(IV) 2 g Q4H with rifampin
Skin and soft tissue infection:
Cellulitis (nonpurulent) in patients without risk for methicillin-resistant S. aureus: (IV) 1 to 2 g Q4H; total duration of therapy is ≥5 days (including oral step-down therapy); may extend up to 14 days

General dosing:
1. Mild to moderate infections: 100 to 150 mg/kg/day Q6H; maximum 4,000 mg/day
2. Severe infections: 150 to 200 mg/kg/day Q4-6H; maximum 12 g/day
Pneumonia:
For infants >3 months: 150 to 200 mg/kg/day Q6-8H
Endocarditis, treatment:
1. 200 mg/kg/day Q4-6H for at least 4 weeks; maximum 12 g/day
2. May use in combination with gentamicin for some resistant organisms
Meningitis/Ventriculitis:
200 mg/kg/day Q6H; maximum 12 g/day
Skin and soft tissue infections:
1. Methicillin-susceptible Staphylococcus aureus (MSSA): 100 to 150 mg/kg/day Q6H; maximum 12 g/day
2. Necrotizing infection due to MSSA: 200 mg/kg/day Q6H; maximum 12 g/day

1. CrCl ≥10 mL/minute: No dosage adjustment necessary
2. CrCl <10 mL/minute: No specific dosage adjustment recommended; however, monitor closely as high oxacillin concentrations and neurotoxicity have been reported in this population
3. Intermittent hemodialysis (thrice weekly): Not significantly dialyzed
4. CRRT: No dosage adjustment necessary

There are no dosage adjustments provided in the manufacturer's labeling.