Oxacillin

BACTOCILL

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Pronunciation: ox-a-SIL-in

Oxacillin ballicule: receptor binding, kinetics and half-life diagram — Mechanism of action: Oxacillin ballicule

What it isPenicillinase-resistant penicillin; methicillin-susceptible staphylococcal infection.

Why this oneIt is nafcillin's close efficacy peer; selection usually turns on formulary and tolerability rather than antibacterial reach.

What limits itHepatotoxicity and interstitial nephritis stand out. It does not cover MRSA and requires frequent administration.

Oxacillin molecular structure (skeletal formula) — Molecular structure: Oxacillin

FDA-approved for

staphylococcal infections (MSSA) (1962)

FDA label

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FDA dosing	Population	Start	Target	Max
Staphylococcal infection, mild-moderate	Adults	250-500 mg IV q4-6h	250-500 mg IV q4-6h
Severe infection	Adults	1 g IV q4-6h	1 g IV q4-6h

Renal Undefined

Hepatic Undefined

Instructions

Administer as continuous or intermittent IV infusion
Premixed frozen container inappropriate for children/infants/neonates — use other dosage forms
Severe staph infections: continue at least 14 days and for ≥48 h after afebrile, asymptomatic, and cultures negative

Available strengths

inj 1, 2 g

Contraindications

History of anaphylactic/hypersensitivity reaction to any penicillin
Dextrose-containing solutions may be contraindicated in patients with corn allergy

Cautions

Serious/fatal anaphylactic reactions; cross-sensitivity with other beta-lactams
Thrombophlebitis with IV use, especially in elderly

Adverse reactions

Allergic reactions: urticaria, pruritus, angioedema, laryngospasm, bronchospasm, hypotension, anaphylaxis

Pregnancy Animal studies show no fetal harm; no adequate well-controlled human studies

Lactation Undefined

Cost

Oxacillin (BACTOCILL)

Strength		#/mo	generic $/unit	CostPlus
1 g	inj	per unit		not offered
2 g	inj	per unit		not offered

NADAC is a voluntary CMS survey of what retail community pharmacies pay for the drugs they stock. Oxacillin is administered under clinical supervision and dispensed outside retail pharmacies, so it rarely appears on surveyed invoices.

Generic entryPre-1982

NO BOXED WARNINGS

Principal riskHepatotoxicity; interstitial nephritis

Classes and tags

Clinical profile

Therapeutic safety burden1 / 4

Overdose danger1 / 4

Weight-gain liability0 / 4

Sedation liability0 / 4

QT / Torsades0 / 4

Direct muscarinic antagonism0 / 4

Embryofetal risk0 / 4

Legacy pregnancy categoryB

Defining liabilityAllergy, gastrointestinal effects and agent-specific renal, hepatic, hematologic or interaction risks.

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