通用药名：Oxacillin Sodium

别名：Prostaphlin, Bactocill, P 12

CA名称：4-Thia-1-azabicyclo[3.2.0]heptane-2-carboxylic acid, 3,3-dimethyl-6-[[(5-methyl-3-phenyl-4-isoxazolyl]carbonyl]amino]-7-oxo-, monosodium salt, (2S,5R,6R)-
苯唑西林;新青霉素Ⅱ;苯唑青霉素;苯唑西林钠;苯唑青霉素钠;苯甲异唑青霉素;苯唑西林/苯唑青霉素;(2S,5R,6R)-3,3-二甲基-6-[(5-甲基-3-苯基-1,2-恶唑-4-甲酰)氨基]-7-氧代-4-硫杂-1-氮杂双环[3.2.0]庚烷-2-羧酸钠盐
 
药理及应用
　　本品为半合成、耐青霉素酶、耐酸青霉素，可口服与注射给药。作用机制同青霉素，但对青霉素敏感阳性球菌的抗菌作用不如青霉素，比青霉素差10倍,本品不为金黄色葡萄球菌产生的青霉素酶所破坏，对产酶金黄色葡萄球菌有效，对不产酶菌株的抗菌作用不如青霉素G。用于耐青霉素G的金黄色葡萄球菌和表皮葡萄球菌的周围感染，对中枢感染一般不适用。主要用于耐青霉素葡萄球菌所致的各种感染，如败血症、心内膜炎、烧伤、骨髓炎、呼吸道感染、脑膜炎、软组织感染等，也可用于化脓性链球菌或肺炎球菌与耐青霉素葡萄球菌所致的混合感染[2]。

药理药动
药效学
参阅青霉素。苯唑西林为耐青霉素酶青霉素，其抗菌作用方式与青霉素相仿。本品对革兰阳性菌和奈瑟菌属有抗菌活性，对耐青霉素金葡菌的最低抑菌浓度为0.4μg/ml，但对青霉素敏感葡萄球菌和各种链球菌的抗菌作用则较青霉素为弱。
药动学
肌内注射苯唑西林 0.5g，半小时血药浓度达峰值，为16.7μg/ml。剂量加倍，血药浓度亦倍增。本品耐酸稳定，口服后吸收良好，30～33％可在肠道吸收；空腹口服本品1g，血药峰浓度于0.5～l小时到达，为11.7μg/ml。食物可影响本品在胃肠道的吸收。3小时内静脉滴注苯唑西林钠 250mg，滴注结束时的平均血浆浓度为9.7μg/ml，2小时后0.16μg/ml。新生儿肌注本品20mg/kg后，8～15天和20～21天新生儿血药峰浓度(平均)分别为51.5和47.0μg/ml。 　　
苯唑西林在肝、肾、肠、脾、胸腔积液和关节腔液均可达有效治疗浓度，腹水中浓度低，痰中的浓度为 0.3～14.5μg/g(平均为2.1μg/g)。本品难以透过正常血脑屏障。蛋白结合率很高，约93％。正常健康人Ｔ1/2为 0.5～0.7小时；8～15天和 20～21天新生儿的Ｔ1/2分别为 1.6和1.2天。本品约 49％(500mg)由肝脏代谢，通过肾小球滤过和肾小管分泌，自肾脏排出体外。肌内注射和口服给药在尿中排出量分别为 40％和 23～30％，10～23％尿中排出的药物为代谢产物。 　　
囊肿性纤维化病人的肾小管分泌功能增强，其清除双氯西林的速率较正常人快 3倍，因此其血药浓度相当低。以苯唑西林等异恶唑组青霉素治疗此种病人时，剂量应加大，而且需监测血药浓度。 　　
    苯唑西林可经胆汁排泄，苯唑西林的胆汁排泄量较其他异恶唑组青霉素者为多。血液透析和腹膜透析皆不能消除苯唑西林。

用量用法
1.静脉滴注：每次１－２g,溶于100ml输液中滴注0.5-1h,每日3-4次。小儿按体重每日50-100mg/kg,分次给予 。肌注：每次1g,每日3-4次。 　　
2.肌内注射或静脉滴注。成人每次0.5～1.0g，每4～6小时一次，病情严重者剂量可增加。小儿体重在40kg以 下者，每6小时按体重12.5～25mg/kg，体重超过40kg者给以成人剂量。

不良反应
①过敏反应:与青霉素G有交叉过敏反应；
②肝毒性:转氨酶升高或引起非特异性肝炎；
③大剂量静脉给药可 引起惊厥；
④血液学异常:如中性白细胞下降。 　　
    更多信息参阅青霉素钠。青霉素引起的各种过敏反应皆可发生于苯唑西林。 　　
    静脉注射苯唑西林偶可产生发热、恶心、呕吐和血清转氨酶升高，肝活检显示非特异性肝炎；停药后症状消失，可能属过敏反应。静脉注射大剂量苯唑西林(每日达 18g)可引起抽搐等神经毒性反应，此反应尤易见于肾功能减退病人。偶见有中性粒细胞减少症或粒细胞缺乏症，急性间质性肾炎伴肾功能衰竭也有报告，婴儿应用大剂量苯唑青霉素后有发生血尿、蛋白尿和尿毒症者。 　　
    苯唑西林毒性极微，临床应用发生反应者较少。口服给药时约15％病人出现胃肠道反应，以轻度中上腹不适、腹胀、食欲减退等为多见。个别病人也可出现恶心、呕吐、腹痛、腹泻等。有时可出现中性细胞减少，但多伴有白细胞减少。有的病人出现肌肉紧张、抽搐、神志不清、头痛、心悸、血清ALT升高、药疹、药热，偶可发生白色念珠菌继发感染，一般较轻，不致影响治疗，对特异质者，可致出血倾向，个别人氨基转移酶升高。肌内注射后，少数病人主诉局部疼痛，且有出现局部硬结者。静脉给药如用量大于10.g／日，最好分两次静滴，浓度不宜过高，速度宜慢。偶见肝炎及胆汁郁滞之病例。大剂量可有神经系统反应，如神志不清，抽搐，惊厥。

注意事项
1.本品可致过敏性休克，用药前应作过敏试验。 　　
2.可出现药疹、药物热、胃肠道反应等。 　　
3.对婴儿大量投用可致血尿、蛋白尿甚至尿毒症。 　　 　　
禁用慎用：对青霉素过敏者禁用。肝病患者及新生儿慎用。

处方须知
①连续大剂量静脉滴注可出现痉挛、神志不清、头痛甚至惊厥等神经系统反应。 　　
②特异质患者可致出血倾向。 　　
③溶解后冷藏不宜超过24h。

适应症
　　主要用于耐青霉素葡萄球菌所致的各种感染，如败血症、呼吸道感染、脑膜炎、软组织感染等，也可用于化脓性链球菌或肺炎球菌与耐青霉素葡萄球菌所致的混合感染。

药物相互作用
　　参阅青霉素钠。在静脉注射液中苯唑西林与庆大霉素、士霉素、四环素、新生霉素、多粘菌素 B、磺胺嘧啶、呋喃妥因、去甲肾上腺素、间羟胺、苯巴比妥、戊巴比妥、水解蛋白、维生素B族、维生素C、琥珀胆碱等呈配伍禁忌。 　　
    苯唑西林在 5％葡萄糖氯化钠注射液中放置 12小时后，其效价减少 12％；当本品加入 5％葡萄糖注射液或氯化钠注射液中，同时有磷酸盐缓冲液存在，则在 21～25℃放置24小时效价无变化。 　　
    阿司匹林、磺胺药在体内外皆可抑制苯唑西林对血清蛋白的结合，磺胺药可减少苯唑西林在胃肠道的吸收。丙磺舒可延长和增高本品的血药浓度。二盐酸奎宁在体外减弱苯唑西林对金葡菌的抗菌活性；苯唑西林与西索米星或奈替米星联合应用可增强苯唑西林对金葡菌的抗菌作用。氨苄西林或庆大霉素与苯唑西林联合后可互相增强对肠球菌的作用。苯唑西林与其他β-内酰胺类抗生素一样，与氨基糖苷类混合后，两者的抗菌活性明显减弱，因此不能在同一容器内给药。

【原产地英文商品名】OXACILLIN(BACTOCILL) 2g/50ml/bag 24bags/case
【原产地英文药品名】OXACILLIN SODIUM/DEXTROSE,ISO-OSMOTIC
【中文参考商品译名】
注：以下产品不同的规格和不同的价格，购买时请以电话咨询为准！
·苯唑西林(BACTOCILL) 2克/50毫升/袋 24袋/箱
·苯唑西林(BACTOCILL) 1克/50毫升/袋 24袋/箱
【中文参考药品译名】苯唑西林钠/葡萄糖,ISO-OSMOTIC
【生产厂家中文参考译名】百特
【生产厂家英文名】BAXTER

Bactocill
Generic Name: oxacillin (ox a SIL in)
Brand Names: Bactocill

What is Bactocill (oxacillin)?
Oxacillin is an antibiotic in the penicillin group of drugs. It fights bacteria in your body.

Oxacillin is used to treat many different types of infections caused by bacteria, such as a staphylococcal (also called "staph") infection.

Oxacillin may also be used for other purposes not listed in this medication guide.

What is the most important information I should know about Bactocill (oxacillin)?
Do not use this medication if you are allergic to oxacillin or to any other penicillin antibiotic, such as amoxicillin (Amoxil), ampicillin (Omnipen, Principen), carbenicillin (Geocillin), dicloxacillin (Dycill, Dynapen), penicillin (Beepen-VK, Ledercillin VK, Pen-V, Pen-Vee K, Pfizerpen, V-Cillin K, Veetids), and others.

Before using oxacillin, tell your doctor if you are allergic to cephalosporins such as Ceclor, Ceftin, Duricef, Keflex, and others, or if you have asthma, liver disease, kidney disease, or a history of any type of allergy.

Oxacillin can make birth control pills less effective, which may result in pregnancy. Before taking oxacillin, tell your doctor if you use birth control pills. Take this medication for the entire length of time prescribed by your doctor. Your symptoms may get better before the infection is completely treated. Oxacillin will not treat a viral infection such as the common cold or flu. Do not share this medication with another person, even if they have the same symptoms you have.

Antibiotic medicines can cause diarrhea, which may be a sign of a new infection. If you have diarrhea that is watery or has blood in it, call your doctor. Do not use any medicine to stop the diarrhea unless your doctor has told you to.

What should I discuss with my healthcare provider before taking Bactocill (oxacillin)?
Do not use this medication if you are allergic to oxacillin or to any other penicillin antibiotic, such as:
amoxicillin (Amoxil, Amoxicot, Biomox, Dispermox, Trimox);
ampicillin (Omnipen, Principen);
carbenicillin (Geocillin);
dicloxacillin (Dycill, Dynapen);
penicillin (Beepen-VK, Ledercillin VK, Pen-V, Pen-Vee K, Pfizerpen, V-Cillin K, Veetids, and others).

Before using oxacillin, tell your doctor if you are allergic to any drugs (especially cephalosporins such as Ceclor, Ceftin, Duricef, Keflex, and others), or if you have:
asthma;
liver disease;
kidney disease;
a bleeding or blood clotting disorder;
a history of diarrhea caused by taking antibiotics; or
a history of any type of allergy.

If you have any of these conditions, you may need a dose adjustment or special tests to safely take oxacillin.

FDA pregnancy category B. This medication is not expected to be harmful to an unborn baby. Tell your doctor if you are pregnant or plan to become pregnant during treatment. Oxacillin can make birth control pills less effective, which may result in pregnancy. Before taking oxacillin, tell your doctor if you use birth control pills. Oxacillin can pass into breast milk and may harm a nursing baby. Do not use this medication without telling your doctor if you are breast-feeding a baby.

How should I take Bactocill (oxacillin)?
Take this medication exactly as it was prescribed for you. Do not take the medication in larger amounts, or take it for longer than recommended by your doctor. Follow the directions on your prescription label.

Take the medicine with a full glass of water. Oxacillin should be taken on an empty stomach, at least 1 hour before or 2 hours after eating a meal.
To be sure this medication is helping your condition, your blood will need to be tested on a regular basis. Your kidney or liver function may also need to be tested. Do not miss any scheduled visits to your doctor.

Take this medication for the entire length of time prescribed by your doctor. Your symptoms may get better before the infection is completely treated. Oxacillin will not treat a viral infection such as the common cold or flu. Do not share oxacillin with another person, even if they have the same symptoms you have.

This medication can cause you to have unusual results with certain medical tests. Tell any doctor who treats you that you are using oxacillin.

Store oxacillin at room temperature away from moisture, heat, and light.

What happens if I miss a dose?
Take the missed dose as soon as you remember. If it is almost time for your next dose, skip the missed dose and take the medicine at your next regularly scheduled time. Do not take extra medicine to make up the missed dose.

What happens if I overdose?
Seek emergency medical attention if you think you have used too much of this medicine.

Overdose symptoms may include confusion, behavior changes, a severe skin rash, urinating less than usual, or seizure (black-out or convulsions).

What should I avoid while taking Bactocill (oxacillin)?
Antibiotic medicines can cause diarrhea, which may be a sign of a new infection. If you have diarrhea that is watery or has blood in it, call your doctor. Do not use any medicine to stop the diarrhea unless your doctor has told you to.

Bactocill (oxacillin) side effects
Get emergency medical help if you have any of these signs of an allergic reaction: hives; difficulty breathing; swelling of your face, lips, tongue, or throat. Call your doctor at once if you have any of these serious side effects:
fever, sore throat, and headache with a severe blistering, peeling, and red skin rash;
diarrhea that is watery or bloody;
fever, chills, body aches, flu symptoms;
easy bruising or bleeding, unusual weakness;
urinating less than usual or not at all;
severe skin rash, itching, or peeling;
agitation, confusion, unusual thoughts or behavior; or
seizure (black-out or convulsions).

Less serious side effects may include:
nausea, vomiting, stomach pain;
vaginal itching or discharge;
headache;
swollen, black, or "hairy" tongue; or
thrush (white patches or inside your mouth or throat).

This is not a complete list of side effects and others may occur. Tell your doctor about any unusual or bothersome side effect. You may report side effects to FDA at 1-800-FDA-1088.

What other drugs will affect Bactocill (oxacillin)?
Before taking oxacillin, tell your doctor if you are using any of the following drugs:
methotrexate (Rheumatrex, Trexall); or
probenecid (Benemid).

This list is not complete and there may be other drugs that can interact with oxacillin. Tell your doctor about all the prescription and over-the-counter medications you use. This includes vitamins, minerals, herbal products, and drugs prescribed by other doctors. Do not start using a new medication without telling your doctor.

Where can I get more information?
Your pharmacist can provide more information about oxacillin.

Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use this medication only for the indication prescribed.

Every effort has been made to ensure that the information provided by Cerner Multum, Inc. ('Multum') is accurate, up-to-date, and complete, but no guarantee is made to that effect. Drug information contained herein may be time sensitive. Multum information has been compiled for use by healthcare practitioners and consumers in the United States and therefore Multum does not warrant that uses outside of the United States are appropriate, unless specifically indicated otherwise. Multum's drug information does not endorse drugs, diagnose patients or recommend therapy. Multum's drug information is an informational resource designed to assist licensed healthcare practitioners in caring for their patients and/or to serve consumers viewing this service as a supplement to, and not a substitute for, the expertise, skill, knowledge and judgment of healthcare practitioners. The absence of a warning for a given drug or drug combination in no way should be construed to indicate that the drug or drug combination is safe, effective or appropriate for any given patient. Multum does not assume any responsibility for any aspect of healthcare administered with the aid of information Multum provides. The information contained herein is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. If you have questions about the drugs you are taking, check with your doctor, nurse or pharmacist.