dicloxacillin

see also:

• penicillins
• antibiotics for Rx of Staph. aureus

• dicloxacillin is a narrow spectrum penicillin active against Gram +ves including St. aureus
• not active against Gram negative bacilli, methicillin resistant Staphylococcus, nor Streptococcus faecalis.
• category B1 in pregnancy
• is excreted in breast milk in trace amounts. An alternative feeding method is recommended to avoid any possible sensitisation of the newborn.
• avoid in neonates - see PI

• HS to penicillins or cephalosporins
• PH flucloxacillin associated jaundice or hepatic dysfunction

• HS reaction including anaphylaxis
• Antibiotic associated pseudomembranous colitis
• cholestatic jaundice - usually after several weeks of Rx, but lower risk than with flucloxacillin
• reduces binding of bilirubin to albumin thus avoid in jaundiced neonates or premature neonates
• sodium load in renally impaired patients
• high doses (2 to 4 g/day) of dicloxacillin administered prophylactically to geriatric patients undergoing arthroplasties have been reported to be associated with elevations of serum creatinine and nephrotoxicity. Renal function should be assessed prior to starting dicloxacillin and doses appropriately reduced in the presence of kidney dysfunction when high doses are being considered.

• adults 500mg qid
• children 6.25 to 12.5 mg/kg qid
• avoid in neonates

• adult dose 500mg - 1g 6hrly
• children: 6.25 to 12.5 mg/kg every six hours (25mg/kg every 6hrs can be given for severe infections)
• avoid in neonates