The Newer Penicillins

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Abstract
Both agents are highly effective against strains of coagulase-positive staphylococci resistant to penicillin G. Both agents are effective against Group A [beta]-hemolytic streptococci and pneumococci. Oxacillin [5-methyl-3-phenyl-4-isox-azolyl penicillin] is slightly less effective than penicillin-G in this respect; methicillin is much less effective. Methicillin is virtually ineffective against enterococci. Methicillin is unstable in solution, especially when the pH is less than 7.0. Solutions for intravenous use should be made freshly and buffered to pH 7.2 to 7.4. Oxacillin can be administered perorally and is well absorbed, which determines its chief advantage over methicillin. Oxacillin must be given on an empty stomach or absorption will be hindered or blocked. Oxacillin is bound to serum. Probenecid increases and prolongs the duration of the serum concentrations attained after a dose of either of the new penicillins, despite the fact that these agents are excreted via both hepatic and renal pathways. Bacterial resistance is not yetof clinical importance.

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