CLOXACILLIN injectable

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.