Klin Farmakol Farm. 2019;33(4):39-41 | DOI: 10.36290/far.2019.038

Prolonged oxacillin infusion in a patient with staphylococcal bacteraemia

Martin Vodička¹, Ilja Ryšavý²

¹ Lékárna, Krajská nemocnice T. Bati, a. s.

² Interní oddělení, Krajská nemocnice T. Bati, a. s.

Oxacillin is effective in treating sepsis caused by methicillin sensitive staphylococcus aureus (MSSA). Given its short elimination half-life, safety profile, stability, and the types of infections treated, oxacillin is a suitable candidate for prolonged infusion administration. Its dosage in chronic kidney disease (CKD) is still a matter of expert discussion. The text presents a case of a polymorbid patient with end-stage renal disease and hypoalbuminemia who was admitted to the intensive care unit (ICU) for MSSA-caused sepsis. The sepsis was successfully treated with standard intermittent intravenous dosage of two grams of oxacillin in a 15 minute infusion every four hours. However, bacteremia and elevated inflammatory markers persisted. Oxacillin infusions were prolonged to three hours, which led to the patient's condition improvement and sterile blood cultures. The patient was transferred to the standard ward. After shortening the infusions, the inflammatory markers rose again. The infusions were prolonged back to three hours with good clinical response. The case supports the effect of prolonged / continuous oxacillin infusion on MSSA bacteriemia and hints at the significance of non-renal clearance. The authors suggest activities for safe prolonged / continuous infusion administration and discusses the drug's pharmacokinetics.

Keywords: oxacillin, staphylococcus aureus, pharmacokinetics.

Received: December 13, 2019; Revised: December 22, 2019; Accepted: December 22, 2019; Prepublished online: December 22, 2019; Published: January 1, 2020  Show citation