Indications

A-Flox (Flucloxacillin) is indicated for treating infections caused by Gram-positive organisms, especially those that produce penicillinase. Its uses include:

• Skin and soft tissue infections: Boils, abscesses, cellulitis, infected wounds, and impetigo.
• Respiratory tract infections: Pneumonia, sinusitis, and tonsillitis.
• Other infections: Osteomyelitis, endocarditis, urinary tract infections, and septicaemia caused by susceptible organisms. It is also used as a prophylactic agent during major surgical procedures, such as cardiothoracic and orthopedic surgery.

Pharmacology

Flucloxacillin is a bactericidal, penicillinase-resistant penicillin antibiotic. It works by inhibiting the final stage of bacterial cell wall synthesis. This weakens the cell wall, causing the bacteria to swell and rupture. Its unique molecular structure provides resistance to bacterial penicillinase enzymes, making it effective against penicillinase-producing staphylococci.

Dosage & Administration

• Oral:
  • Adults: 250 mg four times daily. Dosage may be doubled for severe infections. For osteomyelitis and endocarditis, up to 8 gm daily can be used in 6-8 hourly divided doses.
  • Children (2-10 years): Half of the adult dose.
  • Children (under 2 years): One-quarter of the adult dose.
  • Oral doses should be taken 1 hour before a meal.
• Parenteral (Injection):
  • Adults/Elderly: 250 mg four times daily (Intramuscular) or 250 mg-1 gm four times daily (Intravenous).
  • Children (2-10 years): Half of the adult dose.
  • Children (under 2 years): One-quarter of the adult dose.

Interaction

Concurrent use with an unspecified drug may result in increased and prolonged blood levels of A-Flox.

Contraindications

Flucloxacillin is contraindicated in patients with a known hypersensitivity to penicillin.

Side Effects

Side effects are generally mild and temporary, and may include gastrointestinal disturbances like nausea, vomiting, diarrhoea, and dyspepsia. Other reported side effects include rashes, fever, hepatitis, and cholestatic jaundice.

Pregnancy & Lactation

Flucloxacillin is a US FDA Pregnancy Category B drug. It should be used during pregnancy only if clearly needed. It is excreted in human milk, so caution should be exercised when administered to a lactating mother.

Precautions & Warnings

• Use with caution in patients with hepatic dysfunction or an allergic diathesis.
• In severe renal failure (creatinine clearance <10 ml/min), a reduction in dose or an extension of the dose interval should be considered.

Therapeutic Class

A-Flox belongs to the class of penicillinase-resistant penicillins.

Reconstitution

A-Flox can also be administered by intraarticular or intrapleural injection. Powder for injection can be dissolved in sterile water and inhaled via a nebulizer.

Storage Conditions

Keep in a dry place away from light and heat. Keep out of the reach of children.