Cloxacillin
Cloxacillin is a semisynthetic antibiotic belonging to the penicillin class, specifically the penicillinase-resistant penicillins. It is used for the treatment of infections caused by penicillinase-producing staphylococci, which are resistant to other penicillins. Cloxacillin is effective against a range of bacterial infections, including impetigo, cellulitis, pneumonia, septic arthritis, and otitis externa, but it is not effective against methicillin-resistant Staphylococcus aureus (MRSA)[10].
The drug is available in various forms, including oral capsules, oral powder for reconstitution, and injectable forms. For adults, the recommended dosage of cloxacillin can vary depending on the nature and severity of the infection, with doses ranging from 250 mg to 500 mg taken orally every 6 hours for up to 21 days. The maximum daily dose should not exceed 4 g[1]. For children aged 1 year to 18 years, the dosage is typically 50 to 100 mg/kg/day divided every 6 hours, also with a maximum dose of 4 g/day[1]. It is important to note that the safety and efficacy of cloxacillin in children under 1 year have not been established[1].
Cloxacillin is best absorbed when taken on an empty stomach, preferably 1 to 2 hours before meals[1]. Common side effects include gastrointestinal complaints such as nausea, vomiting, and diarrhea. Rarely, cloxacillin use has been associated with more severe side effects like pseudomembranous colitis, neutropenia, leukopenia, thrombocytopenia, transient increases in serum transaminases, cholestatic hepatitis, and hypersensitivity reactions[2]. It may also decrease the effectiveness of birth control pills, necessitating the use of a second method of birth control[2].
Cloxacillin should not be used by individuals who are allergic to it, penicillin, or cephalosporin[4]. It is contraindicated in patients with a history of such allergies due to the risk of severe allergic reactions, including anaphylaxis[4][15]. The drug may interact with other medications, such as vaccines and certain antibiotics, potentially altering their effects[4][8].
Environmental precautions should be taken to avoid release to the environment, and disposal of waste from residues or contaminated packaging should comply with local regulations[3]. Cloxacillin is not commercially available in the United States but is included in the World Health Organization's List of Essential Medicines for its importance in treating bacterial infections[10].
Citations:
[1] https://www.drugs.com/dosage/cloxacillin.html
[2] https://www.drugs.com/sfx/cloxacillin-side-effects.html
[3] https://www.merck.com/docs/product/safety-data-sheets/ah-sds/Cloxacillin%20Formulation_AH_CA_EN.pdf
[4] https://www.medindia.net/doctors/drug_information/cloxacillin.htm
[5] https://www.webmd.com/drugs/2/drug-8637/cloxacillin-oral/details
[6] https://www.medbroadcast.com/drug/getdrug/cloxacillin-by-pro-doc-limitee
[7] https://www.medbroadcast.com/drug/getdrug/teva-cloxacillin
[8] https://www.healthlinkbc.ca/medications/cloxacillin-injection
[9] https://go.drugbank.com/drugs/DB01147
[10] https://en.wikipedia.org/wiki/Cloxacillin
[11] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5815267/
[12] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1703823/pdf/bripharmchem00033-0127.pdf
[13] https://medicalguidelines.msf.org/en/viewport/EssDr/english/cloxacillin-injectable-16682609.html
[14] https://medicalguidelines.msf.org/en/viewport/EssDr/english/cloxacillin-oral-16683395.html
[15] https://www.drugs.com/cdi/cloxacillin-capsules.html
[16] https://reference.medscape.com/drug/dicloxacillin-342477
[17] https://www.hopkinsguides.com/hopkins/view/Johns_Hopkins_ABX_Guide/540138/all/Cloxacillin
[18] https://fadavispt.mhmedical.com/content.aspx?bookid=1873§ionid=139006340
[19] https://www.pediatriconcall.com/drugs/cloxacillin/440