Oxacillin Dosage
Medically reviewed by Drugs.com. Last updated on Aug 9, 2023.
Applies to the following strengths: 500 mg; 1 g; 10 g; 2 g; 250 mg/5 mL; 250 mg; 4 g; 1 g/50 mL; 2 g/50 mL
Usual Adult Dose for:
- Bacterial Infection
- Endocarditis
- Joint Infection
- Meningitis
- Osteomyelitis
- Skin or Soft Tissue Infection
Usual Pediatric Dose for:
Additional dosage information:
Usual Adult Dose for Bacterial Infection
Mild to moderate infections: 250 to 500 mg IV or IM every 4 to 6 hours
Severe infections: 1 g IV or IM every 4 to 6 hours
Use: For the treatment of infections due to susceptible penicillinase-producing staphylococci
Usual Adult Dose for Endocarditis
American Heart Association (AHA) Recommendations:
- Native valve infective endocarditis (NVE): 2 g IV every 4 hours OR 3 g IV every 6 hours
- Prosthetic valve endocarditis: 2 g IV every 4 hours
Duration of Therapy:
- For complicated right-sided NVE and for left-sided NVE: 6 weeks
- For uncomplicated right-sided NVE: 2 weeks
- For prosthetic valve endocarditis: At least 6 weeks
Comments:
- Recommended for NVE due to oxacillin-susceptible strains of staphylococci
- With other agents, recommended for endocarditis involving prosthetic valve (or other prosthetic material) due to oxacillin-susceptible strains of staphylococci
- Current guidelines should be consulted for additional information.
Usual Adult Dose for Joint Infection
Infectious Diseases Society of America (IDSA) Recommendations: 1.5 to 2 g IV every 4 to 6 hours
Comments:
- Recommended as a substitute for nafcillin to treat prosthetic joint infection due to oxacillin-susceptible staphylococci
- Current guidelines should be consulted for additional information.
Usual Adult Dose for Meningitis
IDSA Recommendations: 9 to 12 g/day IV divided every 4 hours
Comments:
- Recommended as a standard regimen for bacterial meningitis due to methicillin-susceptible Staphylococcus aureus
- Current guidelines should be consulted for additional information.
Usual Adult Dose for Osteomyelitis
IDSA Recommendations: 1.5 to 2 g IV every 4 to 6 hours
Duration of therapy: 6 weeks
Comments:
- Recommended as a preferred regimen for native vertebral osteomyelitis due to oxacillin-susceptible staphylococci
- Alternatively, the total daily dose may be administered via continuous infusion.
- Current guidelines should be consulted for additional information.
Usual Adult Dose for Skin or Soft Tissue Infection
IDSA Recommendations:
- Incisional surgical site infections: 2 g IV every 6 hours
- Skin and soft tissue infection, necrotizing infections: 1 to 2 g IV every 4 hours
Comments:
- Recommended for treatment of incisional surgical site infections associated with surgery of trunk or extremity away from axilla or perineum
- Recommended as a preferred regimen for skin and soft tissue infection due to methicillin-susceptible S aureus and necrotizing infections of the skin, fascia, and muscle due to S aureus
- Current guidelines should be consulted for additional information.
Usual Pediatric Dose for Bacterial Infection
Premature and neonates: 25 mg/kg/day IV or IM
Infants and children weighing less than 40 kg:
- Mild to moderate infections: 12.5 mg/kg IV or IM every 6 hours
- Severe infections: 100 mg/kg/day IV or IM in equally divided doses every 4 to 6 hours
Children weighing at least 40 kg:
- Mild to moderate infections: 250 to 500 mg IV or IM every 4 to 6 hours
- Severe infections: 1 g IV or IM every 4 to 6 hours
Use: For the treatment of infections due to susceptible penicillinase-producing staphylococci
American Academy of Pediatrics Recommendations:
Gestational age up to 34 weeks:
- Postnatal age up to 7 days: 25 mg/kg IV or IM every 12 hours
- Postnatal age greater than 7 days: 25 mg/kg IV or IM every 8 hours
Gestational age greater than 34 weeks:
- Postnatal age up to 7 days: 25 mg/kg IV or IM every 8 hours
- Postnatal age greater than 7 days: 25 mg/kg IV or IM every 6 hours
1 month or older: 100 to 200 mg/kg/day IV or IM divided in 4 to 6 doses
Maximum dose: 12 g/day
Comments:
- Neonates: Higher doses may be needed for meningitis, though safety and efficacy data for dosing neonates with CNS infection are lacking.
- Current guidelines should be consulted for additional information.
Usual Pediatric Dose for Endocarditis
AHA Recommendations:
1 year or older: 200 mg/kg/day IV divided every 4 to 6 hours
Maximum dose: 12 g/day
Duration of therapy: At least 4 to 6 weeks
Comments:
- Recommended as an alternative regimen for infective endocarditis due to staphylococci (S aureus or coagulase-negative staphylococci) susceptible to 1 mcg/mL or less penicillin G
- With or without gentamicin, recommended as a preferred regimen for infective endocarditis due to staphylococci (S aureus or coagulase-negative staphylococci) resistant to 0.1 mcg/mL penicillin G
- Current guidelines should be consulted for additional information.
Usual Pediatric Dose for Meningitis
IDSA Recommendations:
- Neonates 0 to 7 days: 75 mg/kg/day IV divided every 8 to 12 hours
- Neonates 8 to 28 days: 150 to 200 mg/kg/day IV divided every 6 to 8 hours
- Infants and children: 200 mg/kg/day IV divided every 6 hours
Comments:
- Recommended as a standard regimen for bacterial meningitis due to methicillin-susceptible S aureus
- Smaller doses and longer administration intervals may be advisable for very low birth weight neonates (less than 2 kg).
- Current guidelines should be consulted for additional information.
Usual Pediatric Dose for Pneumonia
Pediatric Infectious Diseases Society and IDSA Recommendations:
- Infants and children older than 3 months: 150 to 200 mg/kg/day IV or IM divided every 6 to 8 hours
Comments:
- Recommended as a preferred regimen for community-acquired pneumonia due to methicillin-susceptible S aureus
- Current guidelines should be consulted for additional information.
Usual Pediatric Dose for Skin or Soft Tissue Infection
IDSA Recommendations:
1 month or older:
- Necrotizing infections: 50 mg/kg IV every 6 hours
- Skin and soft tissue infection: 100 to 150 mg/kg/day IV in 4 divided doses
Comments:
- Recommended as a preferred regimen for necrotizing infections of the skin, fascia, and muscle due to S aureus
- Recommended as a preferred regimen for skin and soft tissue infection due to methicillin-susceptible S aureus
- Current guidelines should be consulted for additional information.
Renal Dose Adjustments
Dose adjustment(s) may be required; however, no specific guidelines have been suggested. Caution recommended.
Liver Dose Adjustments
Data not available
Precautions
CONTRAINDICATIONS:
- History of hypersensitivity (anaphylactic) reaction to any penicillin
- Dextrose-containing solutions: Known allergy to corn or corn products
Consult WARNINGS section for additional precautions.
Dialysis
Data not available
Other Comments
Administration advice:
- May administer IM, by direct IV injection (slowly over about 10 minutes), or as a continuous or intermittent IV infusion
- Do not use plastic container in series connections.
- If another agent is used concomitantly, do not physically mix with this drug; administer separately.
- Determine duration of therapy by clinical and bacteriological response of patient.
- Continue therapy for at least 14 days in severe staphylococcal infections.
- Continue therapy for at least 48 hours after patient is afebrile, asymptomatic, and has negative cultures.
Storage requirements:
- Galaxy containers: Store at or below -20C (-4F); thawed solution is stable for 21 days under refrigeration or 48 hours at room temperature; do not refreeze.
- Vials: Store at 20C to 25C (68F to 77F) before reconstitution; the manufacturer product information should be consulted regarding stability periods of reconstituted and/or further diluted solutions at room temperature (25C), under refrigeration (4C), or frozen (-15C).
Reconstitution/preparation techniques:
- Galaxy containers: Thaw frozen container at room temperature (25C [77F]) or in refrigerator (5C [41F]); do not force thaw by immersion in water baths or by microwave irradiation.
- Vials: The manufacturer product information should be consulted.
IV compatibility:
- Compatible reconstitution diluents for vials: Sterile Water for Injection, USP; Sodium Chloride Injection, USP
- Compatible IV solutions for vials: Sterile Water for Injection, USP; 0.9% Sodium chloride Injection, USP; M/6 Molar Sodium Lactate Solution; 5% Dextrose in water; 5% Dextrose in 0.45% sodium chloride; 10% Invert Sugar Injection, USP; Lactated Ringers Solution; 5% Dextrose in Normal Saline; 10% D-Fructose in Water; 10% D-Fructose in Normal Saline; Lactated Potassic Saline Injection; 10% Invert Sugar in Normal Saline; 10% Invert Sugar Plus 0.3% Potassium Chloride in Water; Travert 10% Electrolyte #1; Travert 10% Electrolyte #2; Travert 10% Electrolyte #3
- Do not add supplementary medication.
General:
- Bacteriologic studies recommended to verify causative organisms and susceptibility.
- Duration of therapy varies with type and severity of infection and overall patient condition; endocarditis and osteomyelitis may require a longer duration of therapy.
- Caution recommended with IV administration (especially in elderly patients) due to possibility of thrombophlebitis.
Monitoring:
- General: Clinical and laboratory signs of toxic or adverse effects (pediatric patients); blood cultures (prior to and at least weekly during therapy); blood levels (renally impaired patients)
- Hematologic: White blood cell and differential cell counts (prior to and at least weekly during therapy); hematopoietic function (periodically during prolonged therapy)
- Hepatic: AST and ALT (periodically during therapy); hepatic function (periodically during prolonged therapy)
- Renal: Urinalysis, blood urea nitrogen, and creatinine (periodically during therapy); renal function in elderly patients; renal function (periodically during prolonged therapy)
Patient advice:
- Avoid missing doses and complete the entire course of therapy.
- Contact physician as soon as possible if watery and bloody stools (with or without stomach cramps and fever) develop.
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