Dicloxacillin is a penicillinase-resistant penicillin antibiotic used primarily to treat infections caused by Gram-positive bacteria, including those that produce beta-lactamase enzymes that can inactivate other penicillins.

Description:

Dicloxacillin is a beta-lactam antibiotic that resists breakdown by beta-lactamase enzymes. It is particularly effective against Staphylococcus aureus and other Gram-positive bacteria that produce these enzymes.

Brand Names:

  1. Dycill
  2. Pathocil
  3. Diclocil

Available Forms & Strengths:

  • Oral Tablets/Capsules:
  • Dicloxacillin: Typically available in 250 mg and 500 mg capsules.
  • Oral Suspension:
  • Dicloxacillin: Often available in a liquid form for pediatric use, typically with concentrations such as 125 mg/5 mL.

Uses:

Dicloxacillin is used to treat a variety of infections, including:

  • Skin and Soft Tissue Infections: Such as cellulitis, impetigo, and abscesses.
  • Bone and Joint Infections: Including osteomyelitis.
  • Respiratory Tract Infections: Such as pneumonia and bronchitis, particularly when caused by penicillinase-producing Staphylococcus aureus.
  • Endocarditis: Caused by susceptible strains of Staphylococcus aureus.

Side Effects:

  • Common:
  • Gastrointestinal: Nausea, vomiting, diarrhea.
  • Allergic Reactions: Rash, itching, urticaria.
  • Less Common:
  • Hematologic: Leukopenia, thrombocytopenia, or anemia.
  • Renal: Risk of nephrotoxicity, particularly with high doses or pre-existing renal conditions.
  • Hepatic: Elevated liver enzymes or liver dysfunction.
  • Superinfections: Risk of overgrowth of non-susceptible organisms like Clostridium difficile.

Dose:

  • Adults:
  • Oral: Typically 250 mg to 500 mg every 6 hours, depending on the severity of the infection.
  • Children:
  • Oral: Dosing is typically 25-50 mg/kg/day divided into 3-4 doses, depending on the severity and type of infection.

Contraindications:

  • Hypersensitivity: Known allergy to Dicloxacillin, other penicillins, or beta-lactam antibiotics.
  • Renal Impairment: Use with caution in patients with significant renal dysfunction due to potential risk of drug accumulation.

Drug Interactions:

  • Anticoagulants: Dicloxacillin may enhance the effects of anticoagulants like warfarin.
  • Other Antibiotics: May interact with other antibiotics, potentially affecting efficacy or side effects.
  • Methotrexate: Dicloxacillin may affect renal clearance of methotrexate, increasing the risk of methotrexate toxicity.

Warnings:

  • Allergic Reactions: Serious reactions, including anaphylaxis, can occur. Discontinue immediately if severe allergic symptoms develop.
  • Renal Monitoring: Regular monitoring of renal function is advised, especially in patients with pre-existing kidney issues.
  • Superinfection Risk: Prolonged use can lead to overgrowth of resistant organisms or fungi.

Special Considerations:

  • Pregnancy: Classified as Category B. Generally considered safe during pregnancy, but should be used when clearly needed.
  • Breastfeeding: Dicloxacillin is excreted in breast milk in small amounts. It is usually considered safe for use during breastfeeding, but monitoring for any adverse effects in the infant is recommended.
  • Pediatric Use: Dicloxacillin is used in children, with dosing adjusted based on weight and the severity of the infection.

Doctor Advised:

  • Complete the full course of therapy as prescribed to ensure effectiveness and reduce the risk of resistance.
  • Inform your healthcare provider of any history of allergic reactions to penicillins or other beta-lactam antibiotics.
  • Monitor for side effects, such as gastrointestinal issues or signs of an allergic reaction, and seek medical advice if necessary.

Conclusion:

Dicloxacillin is a beta-lactamase-resistant penicillin effective against many Gram-positive infections, including those caused by penicillinase-producing Staphylococcus aureus. It should be used according to medical advice to manage infections effectively and to prevent resistance and side effects.

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