Oxacillin Dosage

Usual Adult Dose for Endocarditis

Native valve endocarditis due to staphylococci:
Oxacillin 2 g IV every 4 hours or 3 g IV every 6 hours (total 12 g/day) with or without gentamicin 3 mg/kg/day in 2 or 3 divided doses.

Duration: Oxacillin, 6 weeks; gentamicin 3 to 5 days


Prosthetic valve endocarditis due to staphylococci:
Oxacillin 2 g IV every 4 hours or 3 g IV every 6 hours (total 12 g/day) plus rifampin 300 mg orally every 8 hours, with or without gentamicin 3 mg/kg/day in 2 or 3 divided doses.

Duration: Oxacillin and rifampin, 6 weeks or more; gentamicin 2 weeks

Refer to current published guidelines for detailed recommendations.

Usual Adult Dose for Joint Infection

2 g IV or IM every 4 to 6 hours for 3 to 4 weeks, depending on the nature and severity of the infection. Longer therapy, for 6 weeks or more, may be required for prosthetic joint infections. A third-generation cephalosporin, ciprofloxacin, and/or rifampin should be added, depending on the results of the Gram stain.

Usual Adult Dose for Meningitis

2 g IV or IM every 4 hours for 14 days, depending on the nature and severity of the infection.

Usual Adult Dose for Osteomyelitis

2 g IV or IM every 4 hours for 4 to 6 weeks, depending on the nature and severity of the infection. Chronic osteomyelitis may require additional oral antibiotic therapy, possibly for up to 6 months.

Usual Adult Dose for Pneumonia

2 g IV or IM every 4 hours. Therapy should continue for 7 to 10 days if pneumococcus pneumonia is suspected and up to 21 days if other organisms are responsible.

Alternatively, 500 mg to 1 g orally every 4 to 6 hours, depending on the nature and severity of the infection.

Usual Adult Dose for Septicemia

2 g IV or IM every 4 to 6 hours for 14 days, depending on the nature and severity of the infection.

Usual Adult Dose for Sinusitis

1 to 1.5 g IV or IM or 500 mg to 1 g orally every 4 to 6 hours for 10 to 14 days, depending on the nature and severity of the infection.

Usual Adult Dose for Skin or Soft Tissue Infection

1 to 1.5 g IV or IM every 4 to 6 hours for 7 days, or for 3 days after acute inflammation resolves, depending on the nature and severity of the infection.

Alternatively, 500 mg orally every 4 to 6 hours may be used for mild infections or follow-up after initial parenteral therapy:

Usual Pediatric Dose for Bacterial Infection

Neonates:
< 7 days, birthweight < 1200 g: 25 mg/kg IV or IM every 12 hours.
< 7 days, birthweight 1200 to 2000 g: 25 to 50 mg/kg IV or IM every 12 hours.
< 7 days, birthweight > 2000 g: 25 to 50 mg/kg IV or IM every 8 hours.
> 7 days, birthweight < 1200 g: 50 mg/kg/day IV or IM in divided doses every 12 hours.
> 7 days, birthweight 1200 to 2000 g: 25 to 50 mg/kg IV or IM every 8 hours.
> 7 days, birthweight > 2000 g: 25 to 50 mg/kg IV or IM every 6 hours.

1 month to 12 years:
Mild to moderate infections:
Parenteral: 25 to 37.5 mg/kg IV or IM every 6 hours.
Oral: 12.5 mg/kg every 6 hours.

Severe infections: 150 to 200 mg/kg/day IV or IM in equally divided doses every 4 to 6 hours.

Maximum dose: 12 g/day.

Renal Dose Adjustments

CrCl < 10 mL/min: The dose used should be the lower range of the usual dose.

Liver Dose Adjustments

Data not available

Precautions

Oral antibiotics are not recommended for serious, life-threatening infections.

Dialysis

Oxacillin is not dialyzable.

Other Comments

Parenteral therapy should be used initially in severe infections. Oral therapy may be used as follow-up therapy as soon as the clinical condition warrants.

See also...