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Oxacillin Disease Interactions

There are 4 disease interactions with oxacillin:

Major

Antibiotics (applies to oxacillin) colitis

Major Potential Hazard, Moderate plausibility. Applicable conditions: Colitis/Enteritis (Noninfectious)

Clostridioides difficile-associated diarrhea (CDAD), formerly pseudomembranous colitis, has been reported with almost all antibacterial drugs and may range from mild diarrhea to fatal colitis. The most common culprits include clindamycin and lincomycin. Antibacterial therapy alters the normal flora of the colon, leading to overgrowth of C difficile, whose toxins A and B contribute to CDAD development. Morbidity and mortality are increased with hypertoxin-producing strains of C difficile; these infections can be resistant to antimicrobial therapy and may require colectomy. CDAD must be considered in all patients who present with diarrhea after antibacterial use. Since CDAD has been reported to occur more than 2 months after antibacterial use, careful medical history is necessary. Therapy with broad-spectrum antibacterials and other agents with significant antibacterial activity should be administered cautiously in patients with history of gastrointestinal disease, particularly colitis; pseudomembranous colitis (generally characterized by severe, persistent diarrhea and severe abdominal cramps, and sometimes associated with the passage of blood and mucus), if it occurs, may be more severe in these patients and may be associated with flares in underlying disease activity. Antibacterial drugs not directed against C difficile may need to be stopped if CDAD is suspected or confirmed. Appropriate fluid and electrolyte management, protein supplementation, antibacterial treatment of C difficile, and surgical evaluation should be started as clinically indicated.

References

  1. Moriarty HJ, Scobie BA "Pseudomembranous colitis in a patient on rifampicin and ethambutol." N Z Med J 04/23/80 (1980): 294-5
  2. Thomas E, Mehta JB "Pseudomembranous colitis due to oxacillin therapy." South Med J 77 (1984): 532-3
  3. Bauwens JE, McFarland LV, Melcher SA "Recurrent clostridium difficile disease following ciprofloxacin use." Ann Pharmacother 31 (1997): 1090
  4. Davies J, Beck E "Recurrent colitis following antibiotic-associated pseudomembranous colitis." Postgrad Med J 57 (1981): 599-601
  5. Dan M, Samra Z "Clostridium difficile colitis associated with ofloxacin therapy." Am J Med 87 (1989): 479
  6. Harmon T, Burkhart G, Applebaum H "Perforated pseudomembranous colitis in the breast-fed infant." J Pediatr Surg 27 (1992): 744-6
  7. Milstone EB, McDonald AJ, Scholhamer CF Jr "Pseudomembranous colitis after topical application of clindamycin." Arch Dermatol 117 (1981): 154-5
  8. Cone JB, Wetzel W "Toxic megacolon secondary to pseudomembranous colitis." Dis Colon Rectum 25 (1982): 478-82
  9. Burt RA "A review of the drug events reported by 12,917 patients treated with cephalexin." Postgrad Med J 59 (1983): 47-50,51-3
  10. Cannon SR, Dyson PH, Sanderson PJ "Pseudomembranous colitis associated with antibiotic prophylaxis in orthopaedic surgery." J Bone Joint Surg Br 70-B (1988): 600-2
  11. Miller DL, Sedlack JD, Holt RW "Perforation complicating rifampin-associated pseudomembranous enteritis." Arch Surg 124 (1989): 1082
  12. Wang C, Calandra GB, Aziz MA, Brown KR "Efficacy and safety of imipenem/cilastatin: a review of worldwide clinical experience." Rev Infect Dis 7 (1985): s528-36
  13. Miller SN, Ringler RP "Vancomycin-induced pseudomembranous colitis." J Clin Gastroenterol 9 (1987): 114-5
  14. Bernstein L "Adverse reaction to trimethoprim-sulfamethoxazole, with particular reference to long-term therapy." Can Med Assoc J 112 (1975): s96-8
  15. Calandra GB, Brown KR, Grad LC, et al "Review of adverse experiences and tolerability in the first 2,516 patients treated with imipenem/cilastatin." Am J Med 78 (1985): 73-8
  16. Pokorney BH, Nichols TW, Jr "Pseudomembranous colitis. A complication of sulfasalazine therapy in a patient with Crohn's colitis." Am J Gastroenterol 76 (1981): 374-6
  17. Sankarankutty M, McGeorge D, Galasko CS "Pseudomembranous colitis following cephradine prophylaxis." Postgrad Med J 58 (1982): 726-8
  18. Van Ness MM, Cattau EL Jr "Fulminant colitis complicating antibiotic-associated pseudomembranous colitis: case report and review of the clinical manifestations and treatment." Am J Gastroenterol 82 (1987): 374-7
  19. Hutcheon DF, Milligan FD, Yardley JH, Hendrix TR "Cephalosporin-associated pseudomembranous colitis." Am J Dig Dis 23 (1978): 321-6
  20. Gordin F, Gibert C, Schmidt ME "Clostridium difficile colitis associated with trimethoprim-sulfamethoxazole given as prophylaxis for pneumocystis carinii pneumonia." Am J Med 96 (1994): 94-5
  21. Bingley PJ, Harding GM "Clostridium difficile colitis following treatment with metronidazole and vancomycin." Postgrad Med J 63 (1987): 993-4
  22. Hinton NA "The effect of oral tetracycline HCl and doxycycline on the intestinal flora." Curr Ther Res Clin Exp 12 (1970): 341-52
  23. Ring FA, Hershfield NB, Machin GA, Scott RB "Sulfasalazine-induced colitis complicating idiopathic ulcerative colitis." Can Med Assoc J 131 (1984): 43-5
  24. Saginur R, Hawley CR, Bartlett JG "Colitis associated with metronidazole therapy." J Infect Dis 141 (1980): 772-4
  25. Friedman RJ, Mayer IE, Galambos JT, Hersh T "Oxacillin-induced pseudomembranous colitis." Am J Gastroenterol 73 (1980): 445-7
  26. "Multum Information Services, Inc. Expert Review Panel"
  27. Midtvedt T, Carlstedt-Duke B, Hoverstad T, et al "Influence of peroral antibiotics upon the biotransformatory activity of the intestinal microflora in healthy subjects." Eur J Clin Invest 16 (1986): 11-7
  28. Leigh DA, Simmons K, Williams S "Gastrointestinal side effects following clindamycin and lincomycin treatment: a follow up study." J Antimicrob Chemother 6 (1980): 639-45
  29. Altamirano A, Bondani A "Adverse reactions to furazolidone and other drugs. A comparative review." Scand J Gastroenterol Suppl 169 (1989): 70-80
  30. Hecht JR, Olinger EJ "Clostridium difficile colitis secondary to intravenous vancomycin." Dig Dis Sci 34 (1989): 148-9
  31. Brause BD, Romankiewicz JA, Gotz V, Franklin JE Jr, Roberts RB "Comparative study of diarrhea associated with clindamycin and ampicillin therapy." Am J Gastroenterol 73 (1980): 244-8
  32. Boriello SP, Jones RH, Phillips I "Rifampicin-associated pseudomembranous colitis." Br Med J 281 (1980): 1180-1
  33. Klinger D, Radford P, Collin J "Pneumoperitoneum without faecal peritonitis in a patient with pseudomembranous colitis." Br Med J 288 (1984): 1271-2
  34. Saadah HA "Carbenicillin and pseudomembranous enterocolitis." Ann Intern Med 93 (1980): 645
  35. Lyon JA "Imipenem/cilastatin: the first carbapenem antibiotic." Drug Intell Clin Pharm 19 (1985): 894-8
  36. Daly JJ, Chowdary KV "Pseudomembranous colitis secondary to metronidazole." Dig Dis Sci 28 (1983): 573-4
  37. Trexler MF, Fraser TG, Jones MP "Fulminant pseudomembranous colitis caused by clindamycin phosphate vaginal cream." Am J Gastroenterol 92 (1997): 2112-3
  38. Edlund C, Brismar B, Nord CE "Effect of lomefloxacin on the normal oral and intestinal microflora." Eur J Clin Microbiol Infect Dis 1 (1990): 35-9
  39. O'Meara TF, Simmons RA "Carbenicillin and pseudomembranous enterocolitis." Ann Intern Med 92 (1980): 440-1
  40. Meadowcroft AM, Diaz PR, Latham GS "Clostridium difficile toxin-induced colitis after use of clindmycin phosphate vaginal cream." Ann Pharmacother 32 (1998): 309-11
  41. Ehrenpreis ED, Lievens MW, Craig RM "Clostridium difficile-associated diarrhea after norfloxacin." J Clin Gastroenterol 12 (1990): 188-9
  42. Osler T, Lott D, Bordley J, et al "Cefazolin-induced pseudomembranous colitis resulting in perforation of the sigmoid colon." Dis Colon Rectum 29 (1986): 140-3
  43. Parry MF, Rha CK "Pseudomembranous colitis caused by topical clindamycin phosphate." Arch Dermatol 122 (1986): 583-4
  44. Clissold SP, Todd PA, Campoli-Richards DM "Imipenem/cilastatin: a review of its antibacterial activity, pharmacokinetic properties and therapeutic efficacy." Drugs 33 (1987): 185-241
  45. Sugarman B "Trimethoprim-sulfamethoxazole, pseudomembranous colitis, and spinal cord injury." South Med J 78 (1985): 711-3
  46. Golledge CL, Riley TV "Clostridium difficile-associated diarrhoea after doxycycline malaria prophylaxis." Lancet 345 (1995): 1377-8
  47. Edlund C, Lidbeck A, Kager L, Nord CE "Effect of enoxacin on colonic microflora of healthy volunteers." Eur J Clin Microbiol 6 (1987): 298-300
View all 47 references
Major

Penicillinase-resistant PCNs (applies to oxacillin) marrow toxicity

Major Potential Hazard, Moderate plausibility. Applicable conditions: Thrombocytopenia, Neutropenia

The use of penicillinase-resistant penicillins has been associated with adverse hematologic effects, including neutropenia, leukopenia, granulocytopenia and thrombocytopenia, particularly when given in high parenteral dosages. Agranulocytosis and prolonged bleeding time have been reported rarely. Therapy with penicillinase-resistant penicillins should be administered cautiously in patients with preexisting blood dyscrasias or bone marrow depression, and hematopoietic function should be monitored. Blood counts with differential should be performed prior to initiation of therapy and 1 to 3 times weekly during therapy. Hematologic abnormalities are generally reversible and resolve within several days to two weeks following discontinuation of therapy.

References

  1. "Product Information. Staphcillin (methicillin)." Apothecon Inc, Plainsboro, NJ.
  2. "Product Information. Dynapen (dicloxacillin)." Apothecon Inc, Plainsboro, NJ.
  3. Leventhal JM, Silken AB "Oxacillin-induced neutropenia in children." J Pediatr 89 (1976): 769-71
  4. Carpenter J "Neutropenia induced by semisynthetic penicillin." South Med J 73 (1980): 745-8
  5. Brook I "Leukopenia and granulocytopenia after oxacillin therapy." South Med J 70 (1977): 565-6
  6. Clotet B, Vea AM, Rubies-Prat J, Sala MF "Cloxacillin-induced leukopenia." Arch Intern Med 145 (1985): 1531
  7. Slovick FT, Bamberger DM, Stark KR "Spontaneous clostridial myonecrosis in a man with drug-induced agranulocytosis." South Med J 82 (1989): 1272-4
  8. Westerman EL, Bradshaw MW, Williams TW "Agranulocytosis during therapy with orally administered cloxacillin." Am J Clin Pathol 69 (1978): 559-60
  9. Kitzing W, Nelson JD, Mohs E "Comparative toxicities of methicillin and nafcillin." Am J Dis Child 135 (1981): 52-5
  10. Olaison L, Alestig K "A prospective study of neutropenia induced by high doses of B-lactam antiobiotics." J Antimicrob Chemother 25 (1990): 449-53
  11. Ahern MJ, Hicks JE, Andriole VT "Neutropenia during high dose intravenous oxacillin therapy." Yale J Biol Med 49 (1976): 351-60
  12. Alexander DP, Russo ME, Fohrman DE, Rothstein G "Nafcillin-induced platelet dysfunction and bleeding." Antimicrob Agents Chemother 23 (1983): 59-62
  13. "Product Information. Unipen (nafcillin)." Wyeth-Ayerst Laboratories, Philadelphia, PA.
  14. Carpenter J "Neutropenia induced by semisynthetic penicillin." South Med J 73 (1980): 745-8
  15. Jeter EK, Scott A, Kizer J, Lazarchick J "Impaired platelet function associated with parenteral nafcillin." Ann Clin Lab Sci 20 (1990): 79-84
  16. Fallon JA, Tall AR, Janis MG, Brauer MJ "Oxacillin-induced granulocytopenia." Acta Haematol 59 (1978): 163-70
  17. Passoff TL, Sherry HS "Oxacillin induced neutropenia. A case report." Clin Orthop 135 (1978): 69-70
  18. Walbroehl GS, John PG "Antibiotic-associated neutropenia." Am Fam Physician 45 (1992): 2237-41
  19. Alexander DP, Russo ME, Fohrman DE, Rothstein G "Nafcillin-induced platelet dysfunction and bleeding." Antimicrob Agents Chemother 23 (1983): 59-62
  20. Klein JO, Finland M "The new penicillins (concluded)." N Engl J Med 269 (1963): 1129-34
  21. Chu JY, O'Connor DM, Schmidt RR "The mechanism of oxacillin-induced neutropenia." J Pediatr 90 (1977): 668-9
  22. Kahn JB "Oxacillin-induced agranulocytosis." JAMA 240 (1978): 2632
  23. Godin M, Deshayes P, Ducastelle T, Delpech A, Leloet X, Fillastre JP "Agranulocytosis, haemorrhagic cystitis and acute interstitial nephritis during methicillin therapy." J Antimicrob Chemother 6 (1980): 296-7
  24. Couchonnal GJ, Hinthorn DR, Hodges GR, Liu C "Nafcillin-associated granulocytopenia." South Med J 71 (1978): 1356-8
  25. "Product Information. Tegopen (cloxacillin)." Apothecon Inc, Plainsboro, NJ.
  26. "Product Information. Bactocill (oxacillin)." SmithKline Beecham, Philadelphia, PA.
  27. Neftel K, Muller MR, Hauser SP, Walti M, de Weck AL "More on penicillin-induced leukopenia." N Engl J Med 308 (1983): 901-2
  28. Greene GR, Cohen E "Nafcillin-induced neutropenia in children." Pediatrics 61 (1978): 94-7
  29. Shah I, Kumar KS, Lerner AM "Agranulocytosis associated with chronic oral administration of cloxacillin for suppression of staphylococcal osteomyelitis." Am J Hematol 12 (1982): 203-6
View all 29 references
Moderate

Oxacillin (applies to oxacillin) renal dysfunction

Moderate Potential Hazard, Moderate plausibility.

Oxacillin is partially converted by the liver to active and inactive metabolites, and both parent drug and metabolites are eliminated by the kidney. The serum concentrations of oxacillin and its metabolites may be increased and the half-lives prolonged in patients with significantly impaired renal function. In general, dosage adjustments are not necessary in either renal or hepatic impairment, but the lower range of the usual recommended dosage may be appropriate in patients with severe renal impairment (CrCl < 10 mL/min). Renal and liver function tests should be performed periodically during prolonged therapy.

References

  1. Bulger RJ, Lindholm DD, Murray JS, Kirby WM "Effects of uremia on methicillin and oxacillin blood levels." JAMA 187 (1964): 319-22
  2. "Product Information. Bactocill (oxacillin)." SmithKline Beecham, Philadelphia, PA.
  3. Jackson EA, McLeod DC "Pharmacokinetics and dosing of antimicrobial agents in renal impairment, part I." Am J Hosp Pharm 31 (1974): 36-52
  4. Schroder E, Ohm HG, Deupmann FJ "The use of oxacillin in high doses and of amphotericin B in acute renal failure." Ger Med Mon 11 (1966): 368-72
View all 4 references
Moderate

Oxacillin (applies to oxacillin) sodium/potassium

Moderate Potential Hazard, High plausibility. Applicable conditions: Congestive Heart Failure, Fluid Retention, Hypernatremia, Hypertension, Hypokalemia

Each gram of parenteral oxacillin sodium contains approximately 64 to 71 mg (2.8 to 3.1 mEq) of sodium and is buffered with 40 mg of dibasic sodium phosphate. Each 250 mg capsule of oxacillin sodium contains approximately 16 mg (0.7 mEq) of sodium, and each teaspoonful of the 250 mg/5 mL oral solution contains approximately 18 mg (0.8 mEq) of sodium. The sodium content should be considered in patients with conditions that may require sodium restriction, such as congestive heart failure, hypertension, and fluid retention. In addition, hypokalemia has been reported rarely during therapy with the penicillinase-resistant penicillins, which may be particularly important to bear in mind when treating patients with low potassium reserves or fluid and electrolyte imbalance. Clinical monitoring of electrolytes is recommended if these agents are used for prolonged periods.

References

  1. "Product Information. Bactocill (oxacillin)." SmithKline Beecham, Philadelphia, PA.
  2. Schlaeffer F "Oxacillin-associated hypokalemia." Drug Intell Clin Pharm 22 (1988): 695-6
  3. Andreoli SP, Kleiman MB, Glick MR, Bergstein JM "Nafcillin, pseudoproteinuria, and hypokalemic alkalosis." J Pediatr 97 (1980): 841-2

Oxacillin drug interactions

There are 36 drug interactions with oxacillin

Oxacillin alcohol/food interactions

There are 2 alcohol/food interactions with oxacillin

Drug Interaction Classification

These classifications are only a guideline. The relevance of a particular drug interaction to a specific individual is difficult to determine. Always consult your healthcare provider before starting or stopping any medication.
Major Highly clinically significant. Avoid combinations; the risk of the interaction outweighs the benefit.
Moderate Moderately clinically significant. Usually avoid combinations; use it only under special circumstances.
Minor Minimally clinically significant. Minimize risk; assess risk and consider an alternative drug, take steps to circumvent the interaction risk and/or institute a monitoring plan.
Unknown No interaction information available.

Further information

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.