Cloxacillin

General
  • Type: Beta lactamase resistant penicillins
  • Dosage Forms: 125mg/5 ml oral powder, 250mg, 500mg
  • Common Trade Names: Cloxapen, Dry Clox, Tegopen

Adult Dosing

Upper Respiratory Tract Infection
  • 250mg PO q6hrs for 7-14 days

Pneumonia
  • 500mg PO q6hrs for up to 21 days

Soft tissue/skin infection
  • 500mg PO q6hrs for 7 days or until 3 days after acute inflammation resolves

Pediatric Dosing

Upper Respiratory Tract Infection
  • >=1 yr to 18 yrs: 50-100mg/kg/day orally divided every 6 hrs, Max dose 4g/day

Soft tissue and skin infection
  • >=1 yr to 18 yrs: 50-100mg/kg/day orally divided every 6 hrs, Max dose 4g/day

Special Populations
  • Pregnancy Rating: Pregnancy Category B
  • Lactation: acceptable to use during breastfeeding
  • Renal Dosing: no adjustments needed
  • Hepatic Dosing: no adjustments needed

Contraindications
  • Allergy to class/drug

Adverse Reactions

Serious
  • allergic reaction
  • seizures
  • pseudomembranous colitis
  • neutropenia
  • leukopenia
  • thrombocytopenia
  • cholestatic hepatitis
  • hypersensitivity reaction

Common
  • nausea, vomiting
  • diarrhea, abdominal pain
  • thrush/yeast infection

Pharmacology
  • Half-life: 30 min - 1 hr
  • Metabolism: partially metabolized
  • Excretion: renal and biliary
  • Mechanism of Action: bactericidal; adheres to penicillin-binding proteins inhibiting bacterial cell wall synthesis

Antibiotic Sensitivities[1]
Group Organism Sensitivity
Gram PositiveStrep. Group A, B, C, GS
Strep. PneumoniaeS
Viridans strepI
Strep. anginosus gpS
Enterococcus faecalisR
Enterococcus faeciumR
MSSAS
MRSAR
CA-MRSAR
Staph. EpidermidisS
C. jeikeiumR
L. monocytogenesR
Gram NegativesN. gonorrhoeaeR
N. meningitidisR
Moraxella catarrhalisR
H. influenzaeR
E. coliR
Klebsiella spR
E. coli/Klebsiella ESBL+R
E coli/Klebsiella KPC+R
Enterobacter sp, AmpC negR
Enterobacter sp, AmpC posR
Serratia spR
Serratia marcescensX1
Salmonella spR
Shigella spR
Proteus mirabilisR
Proteus vulgarisR
Providencia sp.R
Morganella sp.R
Citrobacter freundiiR
Citrobacter diversusR
Citrobacter sp.R
Aeromonas spR
Acinetobacter sp.R
Pseudomonas aeruginosaR
Burkholderia cepaciaR
Stenotrophomonas maltophiliaR
Yersinia enterocoliticaR
Francisella tularensisX1
Brucella sp.X1
Legionella sp.R
Pasteurella multocidaR
Haemophilus ducreyiX1
Vibrio vulnificusX1
MiscChlamydophila spR
Mycoplasm pneumoniaeR
Rickettsia spX1
Mycobacterium aviumX1
AnaerobesActinomycesR
Bacteroides fragilisR
Prevotella melaninogenicaR
Clostridium difficileX1
Clostridium (not difficile)X1
Fusobacterium necrophorumX1
Peptostreptococcus sp.S

Key
  • S susceptible/sensitive (usually)
  • I intermediate (variably susceptible/resistant)
  • R resistant (or not effective clinically)
  • S+ synergistic with cell wall antibiotics
  • U sensitive for UTI only (non systemic infection)
  • X1 no data
  • X2 active in vitro, but not used clinically
  • X3 active in vitro, but not clinically effective for Group A strep pharyngitis or infections due to E. faecalis
  • X4 active in vitro, but not clinically effective for strep pneumonia

See Also

References
  1. Sanford Guide to Antimicrobial Therapy 2014
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