Dicloxacillin

Indications

Dicloxacillin is used for: Pneumonia, Endocarditis, Impetigo, Cellulitis, Septic Arthritis, Surgical Prophylaxis, Otitis externa, Staphylococcal skin infections, Folliculitis, Boils, Carbuncles, Mastitis, Osteomyelitis, Throat infections, Streptococcus Septicaemia

Adult Dose

Oral Staphylococcus aureus infections 125-500 mg PO q6hr

Child Dose

Child: PO 12–25 mg/kg/day q6h For bone and joint infections, up to 100 mg/kg/day

Renal Dose

Administration

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

Contra Indications

Hypersensitivity to penicillins.

Precautions

Very high doses in poor renal function (risk of neurotoxicity) or heart failure. Skin sensitization may occur on direct contact. Monitor serum K concentration, renal and hematological status. Spirochete infections particularly syphilis; suprainfection with penicillin-resistant organisms with prolonged use; avoid intrathecal route; elderly; porphyria. Lactation: excreted in breast milk, use caution

Pregnancy-Lactation

Pregnancy Category: B Lactation: excreted in breast milk, use caution

Interactions

Probenecid prolongs serum levels of dicloxacillin. Bacteriostatic drugs (e.g. chloramphenicol, tetracyclines) may antagonise the bactericidal effect of dicloxacillin. May reduce anticoagulant response to dicumarol and warfarin. May increase risk of methotrexate toxicity. May diminish the effect of live vaccines (e.g. typhoid vaccine).

Adverse Effects

Side effects of Dicloxacillin : 1-10% Abdominal pain, Diarrhea, Nausea <1% Anemia, Elevated LFTs, Fever, Hypersensitivity, Nephritis, Pseudomembranous colitis, Seizures with extremely high doses &/or renal failure, Rash (maculopapular to exfoliative), Vomiting, Vaginitis Potentially Fatal: Anaphylaxis.

Mechanism of Action

Dicloxacillin has antimicrobial action similar to benzylpenicillin and includes penicillinase-producing and non-penicillinase-producing staphylococci. It is active against streptococci eg, S. pneumoniae and S. pyogenes is < that of benzylpenicillin, but sufficient to be useful when these organisms are present with penicillin-resistant staphylococci. It is ineffective against E. faecalis.