Oxacillin IV Reconstitution and Administration Guidelines
Oxacillin 12g should be mixed in 100-200 mL of compatible IV fluid for each dose when administered in 4-6 equally divided doses throughout the day. 1
Reconstitution Instructions
For direct IV administration, reconstitute oxacillin using Sterile Water for Injection or Sodium Chloride Injection 1:
- Add 10 mL to each 1g vial (or 20 mL to each 2g vial)
- For a 2-3g dose (assuming 12g daily divided into 4-6 doses), use 20-30 mL total reconstitution volume
After reconstitution, further dilute in compatible IV solutions for administration 1:
- Dilute to a concentration of 10-100 mg/mL for optimal stability
- This typically means using 100-200 mL of compatible IV fluid for each 2-3g dose
Compatible IV Solutions
- Recommended diluents for oxacillin include 1, 2:
- 0.9% Sodium Chloride Injection
- Sterile Water for Injection
- 5% Dextrose in Water
- 5% Dextrose in 0.45% Sodium Chloride
- Lactated Ringer's Solution
Stability Considerations
Oxacillin stability varies by concentration and storage conditions 2:
- Room temperature (25°C): Stable for 4 days at 10-100 mg/mL concentration
- Refrigerated (4°C): Stable for 7 days at 10-100 mg/mL concentration
- Frozen (-15°C): Stable for 30 days at 10-100 mg/mL concentration
At lower concentrations (0.5-2 mg/mL), stability is reduced to approximately 6 hours at room temperature 1
Administration Guidelines
- Administer each dose slowly over approximately 10 minutes for direct IV push 1
- For IV infusion, administer at a rate appropriate for the total volume (typically over 30-60 minutes)
- Do not physically mix oxacillin with other medications in the same infusion 1
Important Considerations
- Monitor for signs of thrombophlebitis, particularly in elderly patients 1
- For treatment of endocarditis, therapy should continue for at least 6 weeks for complicated infections 3
- Regular monitoring of liver function is recommended for patients receiving high-dose oxacillin (>6g/day) due to risk of hepatitis 4
- Oxacillin is more stable than other penicillins like ampicillin and nafcillin, exhibiting less than 10% loss after 7 days at room temperature 2