Generic

Flucloxacillin Sodium

Indications

Flucloxacillin is used to treat Gram-positive organism infections, particularly infections caused by penicillinase-producing staphylococci. These are some of the indicators:

• Boils, abscesses, carbuncles, and infected skin diseases are examples of skin and soft tissue infections (e.g. ulcer, eczema, acne, furunculosis, cellulitis, infected wounds, infected burns, otitis media and externa, impetigo).
• Pneumonia, lung abscess, empyema, sinusitis, pharyngitis, tonsillitis, and quinsy are all examples of respiratory tract diseases.
• It is also used to treat various infections caused by Flucloxacillin-sensitive organisms, such as osteomyelitis, enteritis, endocarditis, urinary tract infection, meningitis, and septicaemia.
• It is utilized as a preventative measure for major surgical operations such as cardiothoracic and orthopedic surgery.

Pharmacology

Flucloxacillin is effective against Gram-positive pathogens, including those that produce penicillinase. It has minimal antibacterial action against Gram-negative bacilli. Flucloxacillin works by preventing the development of bacterium cell walls. Flucloxacillin is an isoxazolyl penicillin that combines resistance to penicillinase hydrolysis, stomach acid stability, and action against gram-positive bacteria. Flucloxacillin is a bactericidal antibiotic that is especially effective against staphylococci that produce penicillinase. Flucloxacillin inhibits peptidoglycan production by killing bacterial cellwalls. Peptidoglycan is a heteropolymeric substance that gives mechanical stability to the cell wall. The last stage of peptidoglycan synthesis involves the completion of the cross-linking with the pentaglycin bridge’s terminal glycine residue connecting to the pentapeptide’s fourth residue (D-alanine). Flucloxacillin inhibits the transpeptidase enzyme, which conducts this step. As a result of the weakening bacterial cellwall, the cell expands and ultimately ruptures. Flucloxacillin is resistant to bacterial penicillinase activity, most likely due to steric hindrance caused by the acyl side chain, which inhibits the opening of the – lactam ring.

Dosage & Administration

Oral administration:

• Adult: 250 mg four times daily. Dosage may be doubled in severe infections. In osteomyelitis and endocarditis, up to 8 gm daily is used in 6-8 hourly divided doses.
• Children (2-10 years): 1/2 of adult dose.
• Children (Under 2 years): 1/4 of adult dose.

Parenteral administration:

Adult or Elderly:

• Intramuscular Injection: 250 mg four times daily.
• Intravenous Injection: 250 mg-1 g four times daily by slow injection over 3 to 4 minutes or by intravenous infusion.
• All systemic doses may be doubled in severe infections: doses up to 8 g daily have been suggested for endocarditis or osteomyelitis.

Children:

• 2-10 years: half of the adult dose.
• Under 2 years: a quarter of the adult dose.

Oral doses should be administered 1 hour before meal.

Interaction

Concurrent Flucloxacillin usage may result in elevated Flucloxacillin levels in the blood for an extended length of time.

Contraindications

Flucloxacillin is not recommended for people who are allergic to penicillin.

Side Effects

Some frequent gastrointestinal adverse effects include nausea, vomiting, diarrhoea, dyspepsia, and other mild gastrointestinal problems. Urticaria, purpura, fever, interstitial nephritis, hepatitis, and cholestatic jaundice have also been observed.

Pregnancy & Lactation

Flucloxacillin’s pregnancy category in the United States is B. There have been no appropriate or well-controlled trials in pregnant women. Because animal reproduction studies aren’t usually predictive of human response, this medication should only be taken during pregnancy if absolutely necessary. It has been demonstrated that flucloxacillin is excreted in human milk. As a result, while administering Flucloxacillin to a nursing mother, extreme caution should be taken.

Precautions & Warnings

In individuals with hepatic impairment, flucloxacillin should be administered with care. Patients suffering from allergic diathesis should also be treated with caution.

Therapeutic Class

Penicillins that are resistant to penicillinase

Storage Conditions

Keep away from light and heat in a dry area. Keep out of children’s reach.

Pharmaceutical Name

Beximco Pharma Ltd