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Indications

• Flucloxacillin is effective in treating infections brought on by gram-positive bacteria, including infections brought on by staphylococci that produce penicillinase. These signs consist of:
• Boils, abscesses, carbuncles, and infectious skin diseases are examples of skin and soft tissue infections (such as ulcers, eczema, acne, furunculosis, cellulitis, infectious wounds, infectious burns, external and middle ear otitis, and impetigo ).
• Pneumonia, lung abscess, empyema, sinusitis, pharyngitis, tonsillitis, and Quincy disease are all examples of respiratory tract infections.
• is also used to treat infections caused by flucloxacillin-sensitive microorganisms, including osteomyelitis, enteritis, endocarditis, urinary tract infections, meningitis, and sepsis.

Pharmacology

Flucloxacillin is active against gram-positive bacteria, including penicillinase-producing strains. It has little activity against gram-negative rods. Flucloxacillin works by inhibiting the formation of bacterial cell walls. Flucloxacillin is isoxazole penicillin, which combines resistance to enzymatic hydrolysis of penicillin, gastric acid stability, and activity against Gram-positive bacteria. Flucloxacillin is a bactericidal antibiotic that is particularly useful for Staphylococcus which produces penicillinase. Flucloxacillin destroys the bacterial cell wall, which interferes with peptidoglycan synthesis. Peptidoglycan is a heteromeric structure that provides mechanical stability to the cell wall. The final step of peptidoglycan synthesis involves the completion of cross-linking with the terminal glycine residue of the pentaglycine bridge connected to the fourth pentapeptide residue (Dalanin). The transpeptidase that performs this step is inhibited by flucloxacillin. As a result, the bacterial cell wall weakens, the cell swells and then breaks down. The effect of flucloxacillin against bacterial penicillinase may be due to the steric hindrance caused by the acyl side chain preventing the opening of the β-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 the adult dose.
• Children (Under 2 years): 1/4 of the 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 a meal.

Interaction

Concurrent use of Flucloxacillin and may result in increased levels of Flucloxacillin in the blood for a prolonged period.

Contraindications

Flucloxacillin is contraindicated in penicillin-hypersensitive patients.

Side Effects

Nausea, vomiting, diarrhea, dyspepsia, and other minor gastrointestinal problems are some of the most prevalent gastrointestinal side effects. Urticaria, purpura, fever, interstitial nephritis, hepatitis, and cholestatic jaundice have all been documented in addition to these rashes.

Pregnancy & Lactation

Nausea, vomiting, diarrhea, dyspepsia, and other minor gastrointestinal problems are some of the most prevalent gastrointestinal side effects. Urticaria, purpura, fever, interstitial nephritis, hepatitis, and cholestatic jaundice have all been documented in addition to these rashes.

Precautions & Warnings

In patients with hepatic impairment, flucloxacillin should be taken with caution. In the treatment of patients with allergic diathesis, caution is also advised.

Storage Conditions

Keep in a dry place away from light and heat. Keep out of the reach of children.