CLOXACILLIN injectable

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    Prescription under medical supervision

     

    Therapeutic action

    • Penicillin antibacterial

    Indications

    • Severe infections due to streptococci and/or staphylococci: meningitis, pneumonia, omphalitis, septicaemia of cutaneous origin, endocarditis, osteomyelitis, necrotizing skin and soft tissues infections, etc.
    • Erysipelas, cellulitis

    Forms and strengths, route of administration

    • Powder for injection, in 500 mg vial, to be dissolved in 4 ml of water for injection, for IV infusion in 0.9% sodium chloride or 5% glucose, to be administered in 60 minutes

    Dosage

    Severe infections

    • Neonate:
      •    0 to 7 days (< 2 kg): 50 mg/kg every 12 hours
      •    0 to 7 days (≥ 2 kg): 50 mg/kg every 8 hours
      •    8 days to < 1 month (< 2 kg): 50 mg/kg every 8 hours
      •    8 days to < 1 month (≥ 2 kg): 50 mg/kg every 6 hours
    • Child 1 month and over: 25 to 50 mg/kg every 6 hours (max. 8 g daily)
    • Adult: 2 g every 6 hours (12 g daily for septicaemia, endocarditis, osteomyelitis or if resistance is suspected and in patients ≥ 85 kg)

     

    Age

    Weight

    500 mg vial
    (diluted in 4 ml, 125 mg/ml)

    1 to < 3 months

    4 to < 6 kg

    1 ml x 4

     

    3 months to < 1 year

    6 to < 10 kg

    2 ml x 4

     

    1 to < 5 years

    10 to < 20 kg

    4 ml x 4

    (1 vial x 4)

    5 to < 8 years

    20 to < 28 kg

    8 ml x 4

    (2 vials x 4)

    8 to < 12 years

    28 to < 38 kg

    12 ml x 4

    (3 vials x 4)

    ≥ 12 years and adult

    ≥ 38 kg

    16 ml x 4

    (4 vials x 4)

     

    Dilute each dose of cloxacillin in 5 ml/kg of 0.9% sodium chloride or 5% glucose in children less than 20 kg and in a bag of 100 ml of 0.9% sodium chloride or 5% glucose in children 20 kg and over and in adults.

     

    Erysipelas, cellulitis
    Neonate, child and adult: half of above dose

    Duration

    • Change to oral route as soon as possible with amoxicillin/clavulanic acid or cefalexin depending on the indication. Do not use oral cloxacillin for completion treatment following parenteral therapy.

    Contra-indications, adverse effects, precautions

    • Do not administer to penicillin-allergic patients.
    • Administer with caution to patients with allergy to cephalosporins (cross-sensitivity may occur) or with renal impairment (reduce the dose).
    • May cause: gastrointestinal disturbances (particularly diarrhoea), allergic reactions sometimes severe; rarely, haematological disorders.
    • Do not combine with methotrexate (increased methotrexate toxicity).
    • Pregnancy and breast-feeding: no contra-indication

    Remarks

    • Dicloxacillin, flucloxacillin and oxacillin are used for the same indications.
    • Do not mix with other drugs in the same infusion.

    Storage

     

    – Below 25 °C 
    Reconstituted solution must be used immediately.