Cloxacillin

Therapeutic Class
Penicillin (penicillinase-resistant)
Indications

Treatment of infections caused by penicillinase-producing staphylococci. May be used to initiate therapy in suspected cases of resistant staphylococcal infections prior to the availability of laboratory test results.

Oral
Staphylococcal infections resistant to benzylpenicillin
Adult: 250-500 mg 4 times daily.
Child: 50-100 mg/kg in divided doses every 6 hr.

Incompatibility: Incompatible with aminoglycosides and a number of other antimicrobials.

Contraindications

Hypersensitivity to penicillins.

Warnings / Precautions

Serious and occasionally fatal hypersensitivity (anaphylactic shock with collapse) reactions reported; initiate only after a comprehensive drug and allergy history has been obtained. Caution with history of allergy and/or asthma. Should not be relied upon in patients with severe illness, N/V, gastric dilatation, cardiospasm, or intestinal hypermotility. May result in bacterial resistance with prolonged use or use in the absence of a proven/suspected bacterial infection or a prophylactic indication; take appropriate measures if superinfection develops. Change to another active agent if culture tests fail to demonstrate the presence of staphylococci. Monitor organ system functions (eg, renal, hepatic, and hematopoietic) periodically with prolonged use. If renal impairment is suspected/known, reduce dose and monitor blood levels. Monitor for possible liver function abnormalities.

Adverse Reactions

Allergic reactions, N/V, diarrhea, stomatitis, black or hairy tongue, GI irritation, agranulocytosis, rash, Sore mouth or tongue.
Potentially Fatal: Neuromuscular hypersensitivity; pseudomembranous colitis; anaphylaxis.

Drug Interactions

Co-admin of probenecid or disulfiram may result in higher cloxacillin concentration. Chloramphenicol and tetracycline antagonise bactericidal effect of penicillins.
Potentially Fatal: Increased hypoprothrombinaemic effects of oral anticoagulants.

Lab Interactions

Interferes with urinary glucose tests using cupric sulfate. False-positive results in urine and serum protein, uric acid and urinary steroid tests.

Food Interactions

Delayed absorption in the presence of food.

Mechanism of Actions

Cloxacillin is resistant to degradation by penicillinases. It is particularly useful against penicillinase-producing staphylococci. Highly active against S aureusS pyogenesS viridans and S pneumoniae.
Absorption: Incompletely absorbed from the GI tract with peak plasma concentrations after 1-2 hr (oral); may be reduced in the presence of food. Completely absorbed with peak plasma concentrations after 30 min (IM).
Distribution: Pleural and synovial fluids and bone (therapeutic concentrations), CSF (small amounts except when the meninges are inflamed; crosses the placenta and enters the breast milk. Protein-binding: 94%
Metabolism: Minimal metabolism.
Excretion: Via the urine by glomerular filtration and renal tubular secretion (35% of an oral dose); via the bile (Up to 10%). Not removed by dialysis; 0.5-1 hr (elimination half-life).

Assesment

Assess for drug hypersensitivity, history of allergy/asthma, severe illness, N/V, gastric dilatation, cardiospasm, renal impairment, intestinal hypermotility, pregnancy/nursing status, and possible drug interactions. Obtain bacteriologic studies with susceptibility testing, blood cultures, WBC, and differential cell count prior to therapy.

Monitoring

Monitor for hypersensitivity reactions, development of superinfection, new infection, and renal/hepatic impairment. Monitor organ system function periodically during prolonged therapy. Monitor blood cultures, WBC and differential cell count weekly. Monitor BUN, urinalysis, creatinine, ALT, and AST periodically.

Patient Counselling

Counsel that drug should only be used to treat bacterial, and not viral, infections (eg, common cold). Advise to take exactly ud; inform that skipping doses or not completing full course may decrease effectiveness and increase resistance. Advise not to take drug if with previous allergic reaction to PCN and to inform physician of any allergies or previous allergic reactions to any drugs. Advise to take 1 hr ac or 2 hrs pc. Advise to d/c and notify physician if SOB, wheezing, skin rash, mouth irritation, black tongue, sore throat, N/V, diarrhea, fever, swollen joints, or any unusual bleeding or bruising occurs. Advise to notify physician if taking additional medications, including nonprescription drugs.

Administration

Should be taken on an empty stomach. (Take on an empty stomach 1 hr before or 2 hr after meals.)

Pregnancy Category

B: Drug Pregnancy Category Animal reproduction studies have failed to demonstrate a risk to the fetus and there are no adequate and well-controlled studies in pregnant women OR Animal studies have shown an adverse effect, but adequate and well-controlled studies in pregnant women have failed to demonstrate a risk to the fetus in any trimester.

ATC Classification
J01CF02
GenericPedia Classification
  • Available As
  • Cloxacillin Sodium 1000 mg
  • Cloxacillin 1000 mg
  • Cloxacillin 125 mg
  • Cloxacillin IP 125 mg
  • Cloxacillin Sodium 125 mg
  • Cloxacillin 150 mg
  • Cloxacillin 1500 mg
  • Cloxacillin 25 mg
  • Cloxacillin Sodium 25 mg
  • Cloxacillin IP 250 mg
  • Cloxacillin Sodium 250 mg
  • Cloxacillin 250 mg
  • Cloxacillin 250mg
  • Cloxacillin 50 mg
  • Cloxacillin Sodium 500 mg
  • Cloxacillin IP 500 mg
  • Cloxacillin 500 mg
  • Cloxacillin 62.5 mg
  • Cloxacillin Sodium 62.5 mg
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    One Response to Cloxacillin

    1. March 30, 2014 at 12:18 pm #

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