Oxacillin Dosage

Medically reviewed by Drugs.com. Last updated on Aug 9, 2023.

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

Total dose: 12 g/day

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

Maximum dose: 12 g/day

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

Maximum dose: 12 g/day

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.

Further information

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

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