Flucloxacillin

Flucloxacillin is better absorbed from the gut than cloxacillin.

Indications are infections due to penicillinase producing Staphylococci.

Cautions include:

• history of allergy
• renal impairment

Contra-indications include:

• porphyria
• related to liver disease (1)
  • flucloxacillin should not be used in patients with a history of flucloxacillin-associated jaundice or hepatic dysfunction.
  • flucloxacillin should be used with caution in patients with evidence of hepatic dysfunction
  • careful enquiry should be made concerning previous hypersensitivity reactions to ß-lactams.

Side-effects:

• see 'penicillins (general side-effects)'
• liver disease - flucloxacillin treatment is very rarely associated with an increased risk of hepatic disorders, namely, hepatitis and cholestatic jaundice. In some patients, almost always those with serious underlying disease, these adverse reactions have been fatal (1)
  • onset of hepatic reactions may be delayed for several weeks (up to 2 months) after treatment with flucloxacillin has stopped
  • these reactions are related neither to the dose nor to the route of administration of flucloxacillin
  • risk factors include treatment for more than 2 weeks and increasing age

Routes of administration:

• oral
  • capsules
  • syrups
• i.m.
• slow i.v. injection
• i.v. infusion

The summary of product characteristics must be consulted before prescribing this drug.

Reference:

1. Current Problems in Pharmacovigilance (2004); 30:1-12.