er causes of colitis should also be considered.
Metabolic Reactions
Agranulocytosis, neutropenia, and bone marrow depression have been associated with the use of methicillin sodium, nafcillin, oxacillin, and cloxacillin. Hepatotoxicity, characterized by fever, nausea, and vomiting associated with abnormal liver function tests, mainly elevated SGOT levels, has been associated with the use of oxacillin and cloxacillin.
DOSAGE AND ADMINISTRATION
Oxacillin for Injection can be administered IM or IV; however, the intent of the pharmacy bulk package for this product is for preparation of solutions for IV infusion only.
The penicillinase-resistant penicillins are available for oral administration and for intramuscular and intravenous injection. The sodium salts of methicillin, oxacillin, and nafcillin may be administered parenterally and the sodium salts of cloxacillin, dicloxacillin, oxacillin, and nafcillin are available for oral use.
Bacteriologic studies to determine the causative organisms and their sensitivity to the penicillinase-resistant penicillins should always be performed. Duration of therapy varies with the type and severity of infection as well as the overall condition of the patient, therefore it should be determined by the clinical and bacteriological response of the patient. In severe staphylococcal infections, therapy with penicillinase-resistant penicillins should be continued for at least 14 days. Therapy should be continued for at least 48 hours after the patient has become afebrile, asymptomatic, and cultures are negative. The treatment of endocarditis and osteomyelitis may require a longer term of therapy.
Concurrent administration of the penicillinase-resistant penicillins and probenecid increases and prolongs serum penicillin levels. Probenecid decreases the apparent volume of distribution and slows the rate of excretion by competitively inhibiting renal tubular secretion of penicillin. Penicillin-probenecid therapy is generally limited to those infections where very high serum levels of penicillin are necessary.
Oral preparations of the penicillinase-resistant penicillins should not be used as initial therapy in serious, life-threatening infections (See PRECAUTIONS-General). Oral therapy with the penicillinase-resistant penicillins may be used to follow-up the previous use of a parenteral agent as soon as the clinical condition warrants. For intramuscular gluteal injections, care should be taken to avoid sciatic nerve injury. With intravenous administration, particularly in elderly patients, care should be taken because of the possibility of thrombophlebitis.
RECOMMENDED DOSAGES FOR OXACILLIN FOR INJECTION, USP
|
Drug |
Adults |
Infants and Children
<40 kg (88 lbs) |
Other Recommendations |
|
Oxacillin |
250 to 500 mg IM or IV every 4 to 6 hours (mild to moderate infections) |
50 mg/kg/day IM or IV in equally divided doses every 6 hours (mild to moderate infections) |
|
|
1 gram IM or IV every 4 to 6 hours (severe infections) |
100 mg/kg/day IM or IV in equally divided doses every 4 to 6 hours (severe infections) |
Premature and Neonates 25 mg/kg/day IM or IV |
MPORTANT: This chemical stability information in no way indicates that it would be acceptable practice to use this product well after the
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