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Indications

Flucloxacillin is used to treat infections caused by Gram-positive bacteria, especially those brought on by penicillin-producing staphylococci. Some of the indicators include these:
 

• Boils, abscesses, carbuncles, and other infectious skin diseases are examples of infections of the skin and soft tissues (e.g. ulcer, eczema, acne, furunculosis, cellulitis, infected wounds, infected burns, otitis media and externa, impetigo).
• Respiratory tract conditions include pneumonia, lung abscess, empyema, sinusitis, pharyngitis, tonsillitis, and quinsy. Infections brought on by flucloxacillin-sensitive microorganisms, such as osteomyelitis, enteritis, endocarditis, urinary tract infection, meningitis, and septicemia, are also treated with it.

It is used as a preventive medication when necessary during major surgical procedures like cardiothoracic and orthopedic surgery.

Pharmacology

Flucloxacillin is an isoxazolyl penicillin that combines the qualities of gram-positive bacteria activity, gastric acid stability, and resistance to hydrolysis by penicillinase. A bactericidal antibiotic called flucloxacillin is especially effective against staphylococci that make penicillinase. The steric hindrance caused by the acyl side chain, which prevents the opening of the -lactam ring, is most likely the reason why flucloxacillin resists the action of bacterial penicillinase. Flucloxacillin destroys bacterial cell walls, which prevents the production of peptidoglycan. The heteropolymeric structure known as peptidoglycan gives the cell wall its mechanical stability. The completion of the cross-linking with the terminal glycine residue of the pentaglycin bridge linking to the fourth residue of the pentapeptide marks the end of the peptidoglycan synthesis process (D-alanine). Flucloxacillin inhibits the transpeptidase enzyme, which performs this step. The result is a weakening of the bacterial cell wall, swelling, and eventual rupture of the cell.

Dosage & Administration

Oral management:

• Adult: four doses of 250 mg. In case of serious infections, the dosage may be doubled. Up to 8 gm per day in divided doses of 6–8 hours is used for osteomyelitis and endocarditis.
• Children aged 2 to 10 years: half the adult dosage.
• Under 2-year-olds: 1/4 of the adult dose.

administration via parenteral route: Elderly or Adult

• 250 mg administered intramuscularly four times per day.
• 250 mg to 1 g by slow injection over three to four minutes, or by intravenous infusion, four times per day.

For endocarditis or osteomyelitis, doses up to 8 g per day have been recommended; all systemic doses may be doubled in severe infections.

Children:

• half the adult dose for children 2 to 10.
• 2 years and younger: 25% of the adult dose.

Interaction

Concurrent Flucloxacillin use may result in an elevated Flucloxacillin level in the blood for an extended period of time.

Contraindications

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

Side Effect

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

Pregnancy & Lactation

Flucloxacillin is classified as a pregnancy category B by the US Food and Drug Administration. In pregnant women, there are no adequate and well-controlled studies. Because animal reproduction studies do not always predict human response, this medication should only be used during pregnancy if absolutely necessary.

Precautions & Warnings

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

Storage Conditions

Keep the temperature below 30°C and away from light and moisture. Keep out of children's reach.