FDA approved Oxacillin Injection for Penicillinase-Producing Staphylococcal InfectionsFDA approved Bactocill for certain staph infections in hospitals

Not reported in label.

Oxacillin is indicated for the treatment of infections caused by penicillinase-producing staphylococci that have demonstrated susceptibility to the drug. It may be used to initiate therapy in suspected cases of resistant staphylococcal infections prior to availability of susceptibility test results. It should not be used for infections caused by organisms susceptible to penicillin G. To reduce the development of drug-resistant bacteria, it should be used only to treat or prevent infections that are proven or strongly suspected to be caused by susceptible bacteria.

Oxacillin Injection, USP is supplied as a premixed frozen solution for continuous or intermittent intravenous infusion. The usual adult dosage is 250-500 mg IV every 4-6 hours for mild to moderate infections, and 1 gram IV every 4-6 hours for severe infections. This container system may be inappropriate for children, infants, and neonates; other dosage forms may be more appropriate. Duration of therapy depends on the severity and type of infection and the patient's clinical and bacteriological response. In severe staphylococcal infections, therapy should continue for at least 14 days and for at least 48 hours after the patient is afebrile, asymptomatic, and cultures are negative. Endocarditis and osteomyelitis may require longer therapy. Concurrent probenecid increases and prolongs serum penicillin levels. Do not add supplementary medication to the solution. Thaw frozen container at room temperature or under refrigeration; do not force thaw or refreeze. Thawed solution is stable for 21 days under refrigeration or 48 hours at room temperature.

Trial data not available in label.

Serious and occasionally fatal hypersensitivity reactions, including anaphylactic shock, have occurred in patients receiving penicillin. The incidence of anaphylactic shock is between 0.015% and 0.04%, with death in approximately 0.002% of treated patients. Therapy should be initiated only after a comprehensive drug and allergy history. If an allergic reaction occurs, discontinue the drug and provide supportive treatment. Individuals with a history of penicillin hypersensitivity may also experience allergic reactions to cephalosporins. Clostridium difficile-associated diarrhea (CDAD) has been reported with nearly all antibacterial agents, including oxacillin, and may range from mild diarrhea to fatal colitis. Use with caution in elderly patients due to risk of thrombophlebitis with IV administration.

Oxacillin is a penicillinase-resistant penicillin used for infections caused by susceptible penicillinase-producing staphylococci, such as methicillin-susceptible Staphylococcus aureus. It is an alternative to other antistaphylococcal penicillins and may be used empirically when resistant staphylococcal infection is suspected. It is not effective against methicillin-resistant staphylococci or organisms susceptible to penicillin G. As with all antibiotics, judicious use is recommended to minimize resistance.