Cloxacillin is indicated for the treatment of infections caused by Grampositive organisms including infections caused by ?-lactamase producing Staphylococci such as : Skin and soft tissue infections : Boils, Abscesses, Carbuncles, Furunculosis, Cellulitis, Infected wounds, Infected burns, Otitis media and externa, Protection of skin graft and Skin infections like ulcer, eczema, acne, etc. Respiratory tract infections : Pneumonia, Lung abscess, Empyema, Sinusitis, Pharyngitis and Tonsillitis. Other infections caused by sensitive organisms : Osteomyelitis, Enteritis, Endocarditis, Urinary tract infection, Meningitis and Septicaemia.
Penicillinase-resistant penicillins
Cloxacillin is a semi-synthetic penicillin antibiotic effective against certain bacterial infections, particularly those caused by staphylococci that produce beta-lactamase. Cloxacillin works by binding to penicillin-binding proteins (PBPs) located in the bacterial cell wall. This binding inhibits the enzyme transpeptidase, which is crucial for the cross-linking of peptidoglycan layers in the bacterial cell wall. As a result, cloxacillin disrupts cell wall synthesis, leading to bacterial cell lysis and death. It is particularly effective against beta-lactamase producing staphylococci, which are resistant to many other penicillins.
Upper Respiratory Tract Infection (Adult): Usual Dose: 250 mg orally every 6 hours for 7 to 14 days, depending on the nature and severity of the infection. Maximum dose: 4 g/day. Upper Respiratory Tract Infection (Pediatric): Usual Dose: The safety and efficacy of cloxacillin in children < 1 year have not been established. - 1 year to 18 years: 50 to 100 mg/kg/day orally divided every 6 hours. Maximum dose: 4 g/day. Pneumonia (Adult): Usual Dose: 500 mg orally every 6 hours for up to 21 days, depending on the nature and severity of the infection. Maximum dose: 4 g/day. Pneumonia (Pediatric): Usual Dose: The safety and efficacy of cloxacillin in children < 1 year have not been established. - 1 year to 18 years: 50 to 100 mg/kg/day orally divided every 6 hours. Maximum dose: 4 g/day. Skin and Structure Infection (Adult): Usual Dose: 500 mg orally every 6 hours for 7 days, or until 3 days after acute inflammation resolves, depending on the nature and severity of the infection. Maximum dose: 4 g/day. Skin and Structure Infection (Pediatric): Usual Dose: The safety and efficacy of cloxacillin in children < 1 year have not been established. - 1 year to 18 years: 50 to 100 mg/kg/day orally divided every 6 hours. Maximum dose: 4 g/day. Cystitis: Usual Adult Dose: 250 mg orally every 6 hours for 3 to 7 days, depending on the nature and severity of the infection. Cloxacillin is rarely indicated for the treatment of cystitis. Maximum dose: 4 g/day.
Some notable drugs that interact with cloxacillin include:
Azithromycin: May have interactions that could affect treatment outcomes.
Doxycycline: The therapeutic efficacy of cloxacillin can be decreased when used in combination with doxycycline.
Methotrexate: Cloxacillin may alter the effectiveness of methotrexate, a common chemotherapy drug.
Cloxacillin should not be given to patients known to be hypersensitive to penicillin. Cloxacillin should be given with caution to patients with known history of allergy.
Common side effects are skin rash, transient diarrhoea, nausea, heartburn, pruritus and disturbance of blood electrolyte. Rarely anaphylactic shock.
Pregnancy Category B. Either animal-reproduction studies have not demonstrated a foetal risk but there are no controlled studies in pregnant women or animal-reproduction studies have shown an adverse effect (other than a decrease in fertility) that was not confirmed in controlled studies in women in the 1st trimester (and there is no evidence of a risk in later trimesters).
When penicillin reaches a certain (as yet undetermined) concentration in the cerebrospinal fluid, neurotoxic symptoms may occur consisting of myoclonia, convulsive seizures, and depressed consciousness. Unless administration of the drug is stopped or its dosage reduced, the syndrome may progress to coma and death. Penicillin does not normally cross the blood-brain barrier to any substantial extent, but when massive doses are used (several grams a day) in the presence of inflamed meninges and/or impaired renal function, or in elderly patients, the drug may cause the above- mentioned toxic reactions. No antidote is required.
All dosage forms of cloxacillin should be kept in a cool and dry place. Store Cloxacillin injection vial at no more than 25°C.
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