Index of drugs

Infections caused by staphylococci: infections of the skin, soft tissues (irrigability), lower respiratory tract, purulent postoperative and postoperative complications, osteoarthritis, mainly post-traumatic (in the later stage of treatment, the oral form is administered), sepsis. Before initiating treatment with cloxacillin, a susceptibility test of isolated microbial infection should be performed. Treatment may be implemented before the susceptibility of the organism is obtained. After obtaining the result of the antibiogram, it may be necessary to change the drug accordingly. Where a cloxacillin-sensitive strain is also sensitive to penicillin, benzylpenicillin should be used which has a higher activity than cloxacillin against susceptible strains of staphylococci.

1 vial contains 500 mg or 1 g of cloxacillin in the form of a sodium salt.

Semi-synthetic penicillin, a derivative of isoxazole. The mechanism of bactericidal action of cloxacillin is the inhibition of bacterial cell wall biosynthesis. This antibiotic is characterized by resistance to staphylococcal penicillinases. The antimicrobial activity of cloxacillinin vitro includes Gram-positive bacteriaStaphylococcus spp. - cloxacillin has the strongest effect on staphylococci, also on strains resistant to benzyl penicillin; does not work on methicillin-resistant strains. In addition, it acts on β-hemolytic streptococci,Streptococcus pneumoniae and anaerobic cocci. Cloxacillin acts on gram-negative cocci far less than on staphylococci. Sensitive to her are delusions of the genusNeisseria (Eg.N. gonorrhoeae, N. meningitidis). Although in conditionsin vitro Cloxacillin acts on various strains of Gram-positive and Gram-negative bacteria, the clinic is most often used in infections caused by staphylococci. In infections caused by Gram-negative rods and microbes of the genusEnterococcus Cloxacillin is ineffective. Staphylococcal-resistant staphylococci strains also show resistance to other penicillins and cephalosporins (total cross-resistance). Cloxacillin is stable in an acidic environment, which allows it to be administered orally. After intramuscular administration of 500 mg of cloxacillin, the maximum serum concentration occurs after approx. 30 min. Cloxacillin binds to approximately 95% of blood proteins. T_0,5 is 30-45 min. In patients with renal failure increases up to 1-2 hours. Cloxacillin penetrates well into inflamed bones and joints, pleural fluid, synovial fluid, serous cavities, and oil. It passes through the placenta and into milk. In the cerebrospinal fluid, cloxacillin only permeates inflammation. It is excreted mainly by the kidneys (about 40-60%), by glomerular filtration and tubular excretion, and in a small amount by bile (about 10%).

Hypersensitivity to β-lactam antibiotics.

Before the drug is administered, an accurate history of hypersensitivity to penicillins, cephalosporins or other drugs should be performed due to the risk of anaphylactic reactions. Prolonged use of cloxacillin may occasionally result in the growth of resistant bacteria or yeasts - patients should be carefully observed for signs of superinfection. In the event of severe persistent diarrhea, the possibility of pseudomembranous colitis should be considered - in this case, the drug should be discontinued and appropriate treatment should be started (contraindications are contraindicated). Use with caution in patients with renal insufficiency.

The preparation can be given during pregnancy only if clearly necessary. Caution should be exercised when administering the product during breast-feeding, as the drug is excreted in breast milk and may cause side effects in the fed baby (allergy, diarrhea, yeast infection).

Rare: redness of the skin at the injection site, thrombophlebitis.Very rare: transient eosinophilia, leukopenia, neutropenia, platelet dysfunction, thrombocytopenia, agranulocytosis, bone marrow suppression, haemolytic anemia, neurotoxicity symptoms (transient hyperactivity, agitation, anxiety, drowsiness, disorientation and / or dizziness) - mainly in patients with renal insufficiency receiving high doses of the drug, nausea vomiting; pseudomembranous intestinal inflammation, diarrhea, stomatitis, black hairy tongue, increased transaminases (cholestatic jaundice in individual cases, hepatitis), rash, pruritus, urticaria, erythema multiforme, Stevens-Johnson syndrome, toxic epidermal necrolysis, bullous exfoliative dermatitis (skin rashes may occur 48 h to 2-4 weeks after starting therapy as delayed allergic reactions), anuria, interstitial nephritis, renal tubular dysfunction (symptoms of these disorders are most commonly rash, fever, eosinophilia, hematuria, proteinuria, they are most common in patients receiving high doses of the drug and / or existing kidney problems), fever pain and dizziness, immediate allergic reactions (angioneurotic edema, laryngeal spasm, bronchospasm, decrease in blood pressure, vascular collapse, death), delayed allergic reactions such as fever, malaise, muscle aches, pain in the joints, abdominal pain, skin rashes (may occur 48 hours to 2-4 weeks after starting the therapy), symptoms of serum sickness, allergic vasculitis. Allergic reactions are most common in patients allergic to many allergens, and asthma, hay fever or urticaria in the past, which are administered high doses of the drug, especially parenterally.

Intramuscularly or intravenously. Adults and children weighing over 20 kg: 250-500 mg every 6 hours, in severe infections 1 g every 6 h. The maximum daily dose is 6 g. Children up to 20 kg: usually intravenously 25-50 mg / kg mc. daily in 4 divided doses (every 6 h), in serious infections, the dose can be increased to 100 mg / kg. Patients with renal impairment: it may be necessary to reduce the dose of medication or to prolong the interval between consecutive doses. The duration of treatment depends on the severity and type of infection. The antibiotic should be administered for 2 to 4 days after the symptoms have disappeared. Cloxacillin can be administered by intramuscular or intravenous injection, intravenous infusion or as an injection into the pleural cavity. The solutions should be prepared just before serving.