Indications

Flupen (Flucloxacillin) is indicated for treating infections caused by Gram-positive organisms, particularly those that produce penicillinase. Its indications include:

• Skin and soft tissue infections: Such as boils, abscesses, infected ulcers, cellulitis, and infected wounds.
• Respiratory tract infections: Including pneumonia, bronchitis, and sinusitis.
• Other systemic infections: Including osteomyelitis, endocarditis, urinary tract infections, meningitis, and septicemia caused by susceptible organisms. It is also used as a prophylactic agent during major surgeries, such as cardiothoracic and orthopedic procedures.

Pharmacology

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

Dosage & Administration

• Oral:
  • Adults: 250 mg four times daily. This can be doubled for severe infections.
  • 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:
    • Intramuscular: 250 mg four times daily.
    • Intravenous: 250 mg-1 gm four times daily by slow injection or infusion.
  • Doses up to 8 gm daily may be used for severe infections like endocarditis or osteomyelitis.
  • Children: Half the adult dose for ages 2-10 and one-quarter for under 2 years.

Interaction

The concurrent use of Flupen with an unspecified drug can result in increased blood levels of Flupen for a prolonged period.

Contraindications

Flucloxacillin is contraindicated in patients who are hypersensitive to penicillin.

Side Effects

Common side effects are generally gastrointestinal, including nausea, vomiting, diarrhea, and dyspepsia. Other reported side effects include rashes, urticaria, fever, interstitial nephritis, hepatitis, and cholestatic jaundice.

Pregnancy & Lactation

• Pregnancy: Flucloxacillin is a US FDA Pregnancy Category B drug. It should be used during pregnancy only if clearly needed, as there are no adequate and well-controlled studies in pregnant women.
• Lactation: It is excreted in human milk, so caution should be exercised when administering to a nursing mother.

Precautions & Warnings

• Use with caution in patients with hepatic dysfunction.
• Caution should also be exercised in patients with a history of allergic reactions.
• In severe renal failure (creatinine clearance <10 ml/min), a dose reduction or an extended dose interval should be considered.

Therapeutic Class

Flupen belongs to the penicillinase-resistant penicillins therapeutic class.

Storage Conditions

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