Dicloxacillin: Difference between revisions

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==General==
==General==
*Type:  
*Type: [[Is PenicillinType::Penicillinase-resistant]] [[Is DrugClass::penicillin]]
*Dosage Forms:
*Dosage Forms: 250,500
*Common Trade Names:  
*Common Trade Names:


==Adult Dosing==
==Adult Dosing==
===[[Skin infections]], [[staphylococcal]]===
*125-500mg PO q6h (1h before or 2h after meals)
===[[Osteomyelitis]]===
*250-500mg PO q6h (1h before or 2h after meals)


==Pediatric Dosing==
==Pediatric Dosing==
===[[Skin infections]], [[staphylococcal]]===
*<40 kg: 12.5-25mg/kg/day PO divided q6h
*>40kg: 125-500mg PO q6h
===[[Osteomyelitis]]===
*<40kg: 50-100mg/kg/day PO divided q6h
*>40kg: 250-500mg PO q6h


==Special Populations==
==Special Populations==
*Pregnancy:
*[[Drug pregnancy categories|Pregnancy risk]]: B (no evidence of risk)
*Lactation:
*Lactation: safety unknown
*Renal Dosing
*Renal Dosing
**Adult
**Adult: no adjustment
**Pediatric
**Pediatric: no adjustment
*Hepatic Dosing
*Hepatic Dosing
**Adult
**Adult: not defined
**Pediatric
**Pediatric: not defined


==Contraindications==
==Contraindications==
*Allergy to class/drug
*Allergy to class/drug
*caution in asthma
*caution in seizure disorder
*caution in renal impairment


==Adverse Reactions==
==Adverse Reactions==
===Serious===
===Serious===
*anaphylaxis
*serum sickness-like reaction
*superinfection
*C-diff
*hemolytic anemia
*leukopenia
*agranulocytosis
*neutropenia
*thrombocytopenia
*esophagitis
*esophageal ulcer


===Common===
===Common===
*nausea/vomiting
*diarrhea
*epigastric pain
*urticaria
*pruritus
*fever
*rash
*eosinophilia
*stomatitis
*black hairy tongue
*LFTs elevated


==Pharmacology==
==Pharmacology==
*Half-life:  
*Half-life: 0.7h, if GFR < 10 then 1.8h
*Metabolism:  
*Metabolism: liver partially
*Excretion:  
*Excretion: urine 50-70% (primarily unchanged), bile 10%
*Mechanism of Action:
*Mechanism of Action: inhibits cell wall mucopeptide synthesis
 
==[[Antibiotic Sensitivities]]<ref>Sanford Guide to Antimicrobial Therapy 2014</ref>==
{| class="wikitable"
| align="center" style="background:#f0f0f0;"|'''Group'''
| align="center" style="background:#f0f0f0;"|'''Organism'''
| align="center" style="background:#f0f0f0;"|'''Sensitivity'''
|-
| Gram Positive||[[Strep. Group A, B, C, G]]||'''S'''
|-
| ||[[Strep. Pneumoniae]]||'''S'''
|-
| ||[[Viridans strep]]||I
|-
| ||Strep. anginosus gp||'''S'''
|-
| ||[[Enterococcus faecalis]]||R
|-
| ||[[Enterococcus faecium]]||R
|-
| ||[[MSSA]]||'''S'''
|-
| ||[[MRSA]]||R
|-
| ||[[CA-MRSA]]||R
|-
| ||[[Staph. Epidermidis]]||'''S'''
|-
| ||[[C. jeikeium]]||R
|-
| ||[[L. monocytogenes]]||R
|-
| Gram Negatives||[[N. gonorrhoeae]]||R
|-
| ||[[N. meningitidis]]||R
|-
| ||[[Moraxella catarrhalis]]||R
|-
| ||[[H. influenzae]]||R
|-
| ||[[E. coli]]||R
|-
| ||[[Klebsiella]] sp||R
|-
| ||E. coli/Klebsiella ESBL+||R
|-
| ||E coli/Klebsiella KPC+||R
|-
| ||[[Enterobacter]] sp, AmpC neg||R
|-
| ||[[Enterobacter]] sp, AmpC pos||R
|-
| ||[[Serratia]] sp||R
|-
| ||Serratia marcescens||X1
|-
| ||[[Salmonella]] sp||R
|-
| ||[[Shigella]] sp||R
|-
| ||[[Proteus mirabilis]]||R
|-
| ||[[Proteus vulgaris]]||R
|-
| ||[[Providencia sp.]]||R
|-
| ||[[Morganella sp.]]||R
|-
| ||[[Citrobacter freundii]]||R
|-
| ||[[Citrobacter diversus]]||R
|-
| ||[[Citrobacter sp.]]||R
|-
| ||[[Aeromonas sp]]||R
|-
| ||[[Acinetobacter sp.]]||R
|-
| ||[[Pseudomonas aeruginosa]]||R
|-
| ||[[Burkholderia cepacia]]||R
|-
| ||[[Stenotrophomonas maltophilia]]||R
|-
| ||[[Yersinia enterocolitica]]||R
|-
| ||[[Francisella tularensis]]||X1
|-
| ||[[Brucella sp.]]||X1
|-
| ||[[Legionella sp.]]||R
|-
| ||[[Pasteurella multocida]]||R
|-
| ||[[Haemophilus ducreyi]]||X1
|-
| ||[[Vibrio vulnificus]]||X1
|-
| Misc||[[Chlamydophila sp]]||R
|-
| ||[[Mycoplasm pneumoniae]]||R
|-
| ||[[Rickettsia sp]]||X1
|-
| ||[[Mycobacterium avium]]||X1
|-
| Anaerobes||[[Actinomyces]]||R
|-
| ||[[Bacteroides fragilis]]||R
|-
| ||[[Prevotella melaninogenica]]||R
|-
| ||[[Clostridium difficile]]||X1
|-
| ||[[Clostridium (not difficile)]]||X1
|-
| ||[[Fusobacterium necrophorum]]||X1
|-
| ||[[Peptostreptococcus sp.]]||'''S'''
|}
 
===Key===
{{Template:Antibacterial Spectra Key}}


==See Also==
==See Also==
*[[Antibiotics (Main)]]
*[[Antibiotics (Main)]]


==Source==
==References==
<references/>


<references/>
[[Category:Pharmacology]]
[[Category:Drugs]]
[[Category:ID]]

Latest revision as of 17:41, 18 July 2025

General

  • Type: Penicillinase-resistant penicillin
  • Dosage Forms: 250,500
  • Common Trade Names:

Adult Dosing

Skin infections, staphylococcal

  • 125-500mg PO q6h (1h before or 2h after meals)

Osteomyelitis

  • 250-500mg PO q6h (1h before or 2h after meals)

Pediatric Dosing

Skin infections, staphylococcal

  • <40 kg: 12.5-25mg/kg/day PO divided q6h
  • >40kg: 125-500mg PO q6h

Osteomyelitis

  • <40kg: 50-100mg/kg/day PO divided q6h
  • >40kg: 250-500mg PO q6h

Special Populations

  • Pregnancy risk: B (no evidence of risk)
  • Lactation: safety unknown
  • Renal Dosing
    • Adult: no adjustment
    • Pediatric: no adjustment
  • Hepatic Dosing
    • Adult: not defined
    • Pediatric: not defined

Contraindications

  • Allergy to class/drug
  • caution in asthma
  • caution in seizure disorder
  • caution in renal impairment

Adverse Reactions

Serious

  • anaphylaxis
  • serum sickness-like reaction
  • superinfection
  • C-diff
  • hemolytic anemia
  • leukopenia
  • agranulocytosis
  • neutropenia
  • thrombocytopenia
  • esophagitis
  • esophageal ulcer

Common

  • nausea/vomiting
  • diarrhea
  • epigastric pain
  • urticaria
  • pruritus
  • fever
  • rash
  • eosinophilia
  • stomatitis
  • black hairy tongue
  • LFTs elevated

Pharmacology

  • Half-life: 0.7h, if GFR < 10 then 1.8h
  • Metabolism: liver partially
  • Excretion: urine 50-70% (primarily unchanged), bile 10%
  • Mechanism of Action: inhibits cell wall mucopeptide synthesis

Antibiotic Sensitivities[1]

Group Organism Sensitivity
Gram Positive Strep. Group A, B, C, G S
Strep. Pneumoniae S
Viridans strep I
Strep. anginosus gp S
Enterococcus faecalis R
Enterococcus faecium R
MSSA S
MRSA R
CA-MRSA R
Staph. Epidermidis S
C. jeikeium R
L. monocytogenes R
Gram Negatives N. gonorrhoeae R
N. meningitidis R
Moraxella catarrhalis R
H. influenzae R
E. coli R
Klebsiella sp R
E. coli/Klebsiella ESBL+ R
E coli/Klebsiella KPC+ R
Enterobacter sp, AmpC neg R
Enterobacter sp, AmpC pos R
Serratia sp R
Serratia marcescens X1
Salmonella sp R
Shigella sp R
Proteus mirabilis R
Proteus vulgaris R
Providencia sp. R
Morganella sp. R
Citrobacter freundii R
Citrobacter diversus R
Citrobacter sp. R
Aeromonas sp R
Acinetobacter sp. R
Pseudomonas aeruginosa R
Burkholderia cepacia R
Stenotrophomonas maltophilia R
Yersinia enterocolitica R
Francisella tularensis X1
Brucella sp. X1
Legionella sp. R
Pasteurella multocida R
Haemophilus ducreyi X1
Vibrio vulnificus X1
Misc Chlamydophila sp R
Mycoplasm pneumoniae R
Rickettsia sp X1
Mycobacterium avium X1
Anaerobes Actinomyces R
Bacteroides fragilis R
Prevotella melaninogenica R
Clostridium difficile X1
Clostridium (not difficile) X1
Fusobacterium necrophorum X1
Peptostreptococcus sp. S

Key

  • S susceptible/sensitive (usually)
  • I intermediate (variably susceptible/resistant)
  • R resistant (or not effective clinically)
  • S+ synergistic with cell wall antibiotics
  • U sensitive for UTI only (non systemic infection)
  • X1 no data
  • X2 active in vitro, but not used clinically
  • X3 active in vitro, but not clinically effective for Group A strep pharyngitis or infections due to E. faecalis
  • X4 active in vitro, but not clinically effective for strep pneumonia

See Also

References

  1. ↑ Sanford Guide to Antimicrobial Therapy 2014
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