Thursday, May 25, 2017

Dose Equivalence: Cloxacillin, Flucloxacillin, Oxacillin

Effectiveness
  • Cloxacillin, Dicloxacillin and Flucloxacillin are considered comparable and have similar dose recommendations
  • Oxacillin and  Nafcillin are comparable in effectiveness and indication, however differs in dosing regimen
  • example for MSSA
    • Cloxacillin or flucloxacillin or dicloxacillin 25mg/kg up to 1g q6h
    • Nafcillin or oxacillin 50mg/kg up to 2g q4h
Side Effects
  • Flucloxacillin is reported to have higher, though rare, incidence of severe hepatic adverse effects than dicloxacillin, but a lower incidence of renal adverse effect
Pharmacokinetic
  • flucloxacillin had a significantly longer serum elimination half-life
  • extent of binding of flucloxacillin to the protein of human serum was similar to that of oxacillin and cloxacillin and less than that of dicloxacillin
Reference:
  1. Australian Medicines Handbook 2006. Adelaide: Australian Medicines Handbook; 2006 
  2. www.antimicrobe.org 
  3. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1820086/ 
  4. https://www.nps.org.au/australian-prescriber/articles/what-to-use-instead-of-flucloxacillin 

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