Infectious Disease Book

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Penicillinase-Resistant PenicillinAka: Penicillinase-Resistant Semisynthetic Penicillin, Cloxacillin, Dicloxacillin, Methicillin, Nafcillin, Oxacillin

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  1. See Also
    1. Penicillin
  2. Indications
    1. Staphylococcus Infection
      1. Staphylococcus aureus
      2. Staphylococcus epidermidis
    2. Specific Infections
      1. Skin Infection
      2. Soft tissue infection
      3. Lymphatic infection
      4. Bone infection
      5. Joint infection
  3. Mechanism of Action
    1. Same action to Natural Penicillins
    2. Prevents Penicillinase hydrolysis of Beta lactam ring
  4. Bacterial Resistance mechanisms
    1. Alteration of bacterial cell wall
  5. Oral Preparations
    1. Directions
      1. Take on an empty stomach
      2. Take more than 1 hour before or two hours after food
    2. Cloxacillin (Cloxapen) 250-500 mg PO qid
    3. Dicloxacillin (Dynapen)
      1. Adult: 125 to 500 mg PO qid
      2. Child: 12.5 to 25 mg/kg/day PO divided qid
  6. Parenteral Preparations
    1. Methicillin (Staphcillin)
    2. Nafcillin (Nafcil, Unipen)
      1. Adult: 1 to 2 grams IM or IV every 4 hours
      2. Child: 50 to 200 mg/kg/day divided every 4 to 6 hours
    3. Oxacillin (Bactocill)
      1. Adult: 1 to 2 grams IM or IV every 4 to 6 hours
  7. Activity Spectrum
    1. Same as for Natural Penicillins
  8. Adverse effects
    1. Nephritis (Methicillin)
    2. Venous inflammation (Nafcillin)

Cloxacillin (C0009077)

Definition (MSH)A semi-synthetic antibiotic that is a chlorinated derivative of OXACILLIN.
ConceptsOrganic Chemical (T109) , Antibiotic (T195)
EnglishChloroxacillin, Cloxacillin, CLOXACILLIN PREPARATION
Spanishcloxacilina
CreditsDerived from the NIH UMLS (Unified Medical Language System)


Dicloxacillin (C0012093)

Definition (MSH)One of the PENICILLINS which is resistant to PENICILLINASE.
Definition (NCI)A broad-spectrum, semi-synthetic, beta-lactam, penicillin antibiotic with bactericidal and beta-lactamase resistant activity. Dicloxacillin binds to penicillin binding proteins (PBP) located on the inner membrane of the bacterial cell wall. It also inhibits the cross-linkage of peptidoglycan, a critical component of bacterial cell walls. This leads to the inhibition of bacterial cell wall synthesis and eventually causes cell lysis.
ConceptsOrganic Chemical (T109) , Antibiotic (T195)
EnglishDichloroxacillin, Dicloxaciclin, Dicloxacillin, DICLOXACILLIN PREPARATION, Dicloxacycline
Spanishdicloxacilina
CreditsDerived from the NIH UMLS (Unified Medical Language System)


Methicillin (C0025643)

Definition (MSH)One of the PENICILLINS which is resistant to PENICILLINASE but susceptible to a penicillin-binding protein. It is inactivated by gastric acid so administered by injection.
Definition (CSP)semisynthetic penicillin used as an antibacterial in resistant staphylococcal infections.
ConceptsOrganic Chemical (T109) , Antibiotic (T195)
EnglishDimethoxyphenyl Penicillin, Methicillin, METHICILLIN PREPARATION, Meticillin
Spanishmeticilina
CreditsDerived from the NIH UMLS (Unified Medical Language System)


Nafcillin (C0027324)

Definition (MSH)A semi-synthetic antibiotic related to penicillin.
Definition (NCI)A semi-synthetic naphthalene and beta-lactam antibiotic with antibacterial activity. Nafcillin inhibits bacterial wall synthesis by a mechanism of action similar to penicillin. Penicillinase-resistant Nafcillin is used to treat infections caused by penicillin-resistant strains of Staphylococci. (NCI04)
ConceptsOrganic Chemical (T109) , Antibiotic (T195)
EnglishNafcillin, NAFCILLIN PREPARATION, Naphthamidopenicillin
Spanishnafcilina
CreditsDerived from the NIH UMLS (Unified Medical Language System)


Oxacillin (C0029983)

Definition (MSH)An antibiotic similar to FLUCLOXACILLIN used in resistant staphylococci infections.
Definition (NCI)A semisynthetic penicillinase-resistant and acid-stable penicillin with an antimicrobial activity. Oxacillin binds to penicillin-binding proteins in the bacterial cell wall, thereby blocking the synthesis of peptidoglycan, a critical component of the bacterial cell wall. This leads to inhibition of cell growth and causes cell lysis.
ConceptsOrganic Chemical (T109) , Antibiotic (T195)
EnglishMethylphenyl isoxazolyl penicillin, Methylphenylisoxazolyl Penicillin, Oxacillin, OXACILLIN PREPARATION, Oxazocilline
Spanishmetilfenil isoxazolil penicilina, oxacilina
CreditsDerived from the NIH UMLS (Unified Medical Language System)



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