Oxacillin Administration in 500cc Bag Over 24 Hours
No, oxacillin should not be mixed in a 500cc bag and administered over 24 hours due to stability concerns and recommended dosing guidelines. 1
Stability and Administration Guidelines
- Oxacillin has limited stability in intravenous solutions, particularly at room temperature. At concentrations of 0.5-2 mg/mL, oxacillin maintains stability for only 6 hours at room temperature 1
- For higher concentrations (10-100 mg/mL), stability extends to 4 days at room temperature or 7 days under refrigeration 1
- The FDA-approved administration guidelines recommend dividing the daily dose into 4-6 equal administrations rather than continuous infusion over 24 hours 1
Recommended Administration Methods
- For intravenous administration, oxacillin should be reconstituted with Sterile Water for Injection or Sodium Chloride Injection 1
- Direct IV administration: Add 10 mL to 1 gram vial or 20 mL to 2 gram vial and administer slowly over approximately 10 minutes 1
- For IV drip: Reconstitute as directed for direct IV use, then dilute with appropriate IV solution 1
- The standard dosing for severe infections like endocarditis is 12g per 24 hours IV divided in 4-6 equally divided doses 2
Clinical Considerations
- Administering oxacillin over 24 hours would result in suboptimal drug concentrations, potentially compromising treatment efficacy, especially for serious infections 2
- Studies of experimental enterococcal endocarditis suggest that maintaining trough antibiotic concentration above the MIC is critical, which would be difficult with 24-hour infusion 2
- Tissue necrosis is a potential risk with oxacillin extravasation, particularly with higher concentrations, making shorter infusion times with careful monitoring preferable 3
Alternative Administration Options
- For patients requiring IV oxacillin, the drug should be administered in divided doses (every 4-6 hours) as recommended in treatment guidelines 2, 1
- If extended administration is necessary for logistical reasons, consider:
Monitoring Recommendations
- For patients receiving high-dose intravenous oxacillin therapy, regular monitoring of liver function is recommended due to the risk of oxacillin-associated hepatitis 5
- Monitor infusion sites closely for signs of extravasation or tissue irritation 3
Remember that proper administration of oxacillin according to established guidelines is essential for ensuring optimal treatment outcomes while minimizing potential adverse effects.