What Factors Affect a Sufficient Flucloxacillin Dose?

Flucloxacillin is a semi-synthetic penicillin-resistant penicillin. It is an isoxazole derivative of penicillin. It is chemically related to three other isoxazole penicillins (cloxacillin, dicloxacillin, Oxazocillin) is similar. Mainly by inhibiting the biosynthesis of bacterial cell walls, accelerating the decomposition of bacterial cell walls, thereby playing an antibacterial effect. This product can be administered orally or parenterally. Flucloxacillin is mainly used clinically for various peripheral infections caused by staphylococci. But it is not effective for methicillin-resistant Staphylococcus aureus (MRSA).

Drug Name: Flucloxacillin
Alias: Flucloxacillin, flucloxacillin penicillin, flucloxacillin penicillin, flucloxacillin, flufloxacin, Flucloxacillin, Floxacillin, Flucloxacillinum, Flucloxaxin
Foreign name: flucloxacillin

Whether prescription drugs: prescription
Main indications: Flucloxacillin is used for various peripheral infections caused by Staphylococcus
Dosage form: Liquid bottle
Approval Number: National Medicine Standard H20055810
Drug type: antibiotic

Brief introduction of flucloxacillin compounds

Flucloxacillin, English name Flucloxacillin (INN), also known as flucloxacillin sodium penicillin sodium, flucloxacillin, flucloxacillin sodium, flucloxacillin, flufloxacin, orfoline, flucloxacillin sodium . It is a semi-synthetic penicillin resistant to penicillinase.

Flucloxacillin Basic Information

Chinese name: flucloxacillin

Chinese alias: (2S, 5R, 6R) -6-[[3- (2-chloro-6-fluorophenyl) -5-methyl-1,2-oxazole-4-formyl] amino] -3 , 3-Dimethyl-7-oxo-4-thia-1-azabicyclo [3.2.0] heptane-2-carboxylic acid; Foloxapine; Flucloxacillin;

English name: flucloxacillin

English alias: Staphylex; FK 900; Flucloxacillin; Penplus; Flupen

CAS number: 5250-39-5

Molecular formula: C ₁₉ H ₁₇ ClFN ₃ O ₅ S

Chemical structure:

Molecular weight: 453.87200

Exact mass: 453.005600

PSA: 138.04000

LogP: 3.01660 ^[1]

Physical and Chemical Properties of Flucloxacillin

Appearance and properties: white to off-white free-flowing crystalline powder

Density: 1.59 g / cm ³

Boiling point: 677.3ºC at 760 mmHg

Flash point: 363.4ºC ^[1]

Introduction to Flucloxacillin

Drug name	Flucloxacillin
Drug alias	Flucloxacillin, flucloxacillin penicillin, flucloxacillin penicillin, flucloxacillin, flufloxacin, Flucloxacillin, Floxacillin, Flucloxacillinum, Flucloxaxin
English name	Flucloxacillin
Description	Tablets (free acid): 125mg per tablet. Flucloxacillin sodium for injection: 500mg per bottle; 1000mg.
Function	The antibacterial spectrum of this product is similar to that of oxacillin, and it is resistant to -lactamase produced by Staphylococcus. Intramuscular injection of the same amount of this product and clozacillin, the blood concentration of this product is significantly higher, and the effective concentration in blood is maintained for a longer time. It is mainly used for various peripheral infections caused by staphylococci, but it is not effective against methicillin-resistant Staphylococcus aureus (MRSA) infection.
Indication	Flucloxacillin is mainly used clinically for various peripheral infections caused by staphylococci. But it is not effective for methicillin-resistant Staphylococcus aureus (MRSA).
category	antibiotic

Application of flucloxacillin

For Streptococcus spp. Such as hemolytic streptococcus, Streptococcus pneumoniae and non-green

Flucloxacillin The staphylococci of the mycolytic enzyme have a good antibacterial effect. Moderate antibacterial effect on Enterococcus, Neisseria gonorrhoeae, Neisseria meningitidis, Corynebacterium diphtheria, Bacillus anthracis, Bovine actinomycetes, Streptococcus candida, Listeria, Leptospira and Treponema pallidum This product is sensitive. This product also has certain antibacterial activity against Haemophilus and Bordetella pertussis, and other Gram-negative aerobic or facultative anaerobic bacteria are less sensitive to this product. This product is sensitive to Clostridium sp Aerobic bacteria and Bacteroides melanogaster have good antibacterial effect, but they have poor antibacterial effect on B. fragile. Penicillin exerts a bactericidal effect by inhibiting the binding of bacterial cell wall tetrapeptide chains and pentapeptide cross-linking bridges to hinder cell wall synthesis. It is effective against Gram-positive bacteria. Penicillin has little effect on Gram-negative bacteria due to the lack of a pentapeptide bridge. ^[2]

Flucloxacillin Pharmacokinetics

This product is not absorbed orally. After intramuscular injection of 1g, the peak plasma concentration reached after 0.8h, which was 44.6mg / L, and the bioavailability was 89.5%. Wide distribution volume, 20.6L. Eliminate half-life 1.9h. Immediate blood concentration of 134 mg / L by intravenous bolus injection (10 min bolus) was 134 mg / L: about 70% was excreted in the original form within 24 hours, and about 1% to 2% was excreted by feces. 4 hours of hemodialysis can clear this product, 25% to 50%, 6 hours of peritoneal dialysis removes only 10%. The protein binding rate of this product is 45% 60%. Widely distributed in the body, can be distributed to body tissues and fluids, milk

Flucloxacillin Medium content; effective concentration in cerebrospinal fluid during meningitis. ^[3]

Notes for Flucloxacillin

1. Cross-allergy between flucloxacillin and penicillins, cephalosporins, or penicillamine.

2. Those who are allergic to this product and other penicillins, cephalosporins or penicillamine are prohibited.

3. Use with caution in patients with liver and kidney dysfunction, and with caution in patients with a history of asthma or allergic reactions to other drugs.

4. Fever, rash, pruritus symptoms during or after treatment with flucloxacillin

Flucloxacillin Patients should monitor liver function. It is recommended that inpatients check liver function before treatment and 7 days after oral or intravenous flucloxacillin.

Adverse reactions of flucloxacillin

1. Gastrointestinal reactions such as nausea, vomiting, bloating, diarrhea, and loss of appetite are more common when administered orally.

2. Nervous system reactions such as convulsions, convulsions, unconsciousness, and headaches can occur when using large doses of flucloxacillin.

3. Large-dose use of flucloxacillin occasionally reduces neutrophils, which can cause bleeding tendency in specific constitutions.

4. A few patients can cause acute cholestasis and elevated aminotransferase after administration.

5. Allergic reactions such as drug rash and drug fever can be seen after application.

6. Long-term medication can cause bacterial imbalance and cause double infection.

7, intramuscular injection or intravenous administration can cause pain at the injection site,

Flucloxacillin Sclerosis, severe cases can cause thrombophlebitis. ^[4]

Flucloxacillin drug interactions

1. The combination of this drug and amikacin can enhance the antibacterial effect on Staphylococcus aureus.

2. Use of flucloxacillin and typhoid vaccine can reduce the immune response of typhoid vaccine.

3. Probenecid can affect the excretion of this drug and increase the blood concentration of this drug

4. The combined use of flucloxacillin and methotrexate can reduce the area under the concentration curve (AUC) of methotrexate, but this result is only statistically significant and has no clinical significance.

5. It has been reported that the combined use of flucloxacillin and aminoglycosides will lead to the inactivation of aminoglycosides in vivo and in vitro, which will reduce the efficacy of aminoglycosides.

6. Food can significantly delay the absorption of furocicillin and make its plasma peak

Flucloxacillin Reduce the concentration by 50%. ^[5-6]

Instructions for Flucloxacillin

1. Flucloxacillin should be tested for skin allergies before use. Those who have a positive skin test should not use this drug.

2. Flucloxacillin is contraindicated with aminoglycosides, ciprofloxacin, pefloxacin, etc. When combined, they cannot be placed in the same container.

3. The compatibility of flucloxacillin with blood, plasma, hydrolyzed protein, amino acids and fat milk is contraindicated.

4. Sometimes allergic reactions such as drug fever and drug rash can be seen. A few people may have secondary infection with Candida albicans.

5. Flucloxacillin should be taken 1 hour before or 2 hours after a meal to facilitate absorption.

6. Intravenous injection rate of flucloxacillin should be slow, each time should not be less than 3-4 minutes.

Flucloxacillin usage and dosage

Oral: 250mg each time, 3 times a day; severe dose is 500mg each time, 4 times a day, taken on an empty stomach 0.5-1 hours before eating.

Intramuscular injection: 250mg each time, 3 times a day; 500 mg each time, 4 times a day.

Intravenous injection: 500mg each time, 4 times a day, dissolving the drug in 10-20mL injection

Flucloxacillin Water injection or dextrose infusion, every 4-6 hours. The daily amount should not exceed 8g.

Children: 1/4 of the amount of adults under the age of 2; 1/2 of the amount of adults from the age of 2-10 years, adjusted appropriately according to weight. Can also be divided into 25-50mg / kg daily.

Flucloxacillin

Flucloxacillin (free acid): 125mg. Storage method: Store tightly closed and protected from light at room temperature.

Flucloxacillin sodium for injection (1) 250mg (2) 500mg (3) 1000mg. Storage method: Store tightly closed and protected from light at room temperature.

Flucloxacillin capsule (1) 250mg (2) 500mg. Storage method: Store tightly closed and protected from light at room temperature.

Flucloxacillin syrup 5mL: 125mg. Storage method: Store tightly closed and protected from light at room temperature.

Flucloxacillin Flucloxacillin Sodium Capsule Instructions

Instructions for Flucloxacillin Sodium Capsules

Approval Number

National Medicine Standard H20055810

Chinese name

Flucloxacillin sodium capsules

[Product English name]

FlucloxacillinSodium Capsules

[Indications]

Soft tissue infections, such as abscesses, palate, palate, cellulitis, wound infections, burns, otitis media, skin graft protection, skin ulcers, eczema, acne, surgical preventive medications; respiratory infections, such as pneumonia, empyema, lung abscess , Sinusitis, pharyngitis, and tonsillitis; other infections, such as endocarditis, meningitis, sepsis, Neisseria infection, sepsis abortion, puerperal infection, and osteomyelitis. ^[6]

chemical composition

Flucloxacillin sodium monohydrate.

[Pharmacological action]

Shijunning Jiaoxiang contains flucloxacillin sodium monohydrate equivalent to 250 mg of flucloxacillin; Shijunning powder contains flucloxacillin sodium monohydrate equivalent to 500 mg of flucloxacillin. The injection powder is dissolved in a certain amount of water for injection or 0.5% lidocaine to form a colorless transparent liquid. This drug is semi-synthetic isoxazole penicillin. It is acid-resistant penicillin. It has a protected central -lactam ring through side chain changes, which has the effect of anti-penicillinase. Penicillinase of Staphylococcus. The antibacterial spectrum of this medicine is similar to that of o-chloropenicillin. Staphylococcus aureus, Streptococcus pyogenes, Streptococcus aureus, Streptococcus pneumoniae, Bacillus anthracis, Listeria monocytogenes, Listeria monocytogenes, are resistant or sensitive to penicillin. , Corynebacterium diphtheria, Neisseria gonorrhoeae and Neisseria meningitis are effective. ^[6]

medicine interactions

1 Bacteriostatic antibiotics (tetracycline and erythromycin) can fight the bactericidal effect of this medicine.

2 This medicine cannot be used in combination with colistin sodium methanesulfonate, gentamicin, kanamycin and polymyxin B.

3 Probenecid reduces renal excretion of this medicine.

4 This medicine cannot be mixed with amino acid solutions, fatty milk and blood. ^[6]

Adverse reactions

1 Occasional gastrointestinal side effects such as mild and transient nausea, vomiting, and diarrhea.

2 Occasionally hepatitis and cholestatic jaundice.

3 Like other penicillins, pseudomembrane enteritis is rare.

4 Visible typical allergic reactions such as urticaria, purpura, macular rash and maculopapular rash.

5 High-dose parenteral administration can cause neurotoxicity, neutropenia, and leukocytopenia.

6 Thrombophlebitis has been observed intravenously. ^[6]

Contraindications

People who are allergic to penicillin or other ingredients of this product.

[Product Specifications]

0.25g (as C19H17ClFN3O5S)

Dosage

Adults: One capsule each time, four times a day; should be taken at least half an hour before meals, severe infections, double the dose.

Children's reference dosage: According to foreign species descriptions and literature records, children under 2 years old should be administered as 1/4 of the adult oral dose; 2-10 years old as the adult dose. ^[5]

storage

The drug can be stored at room temperature (15-25 ° C). Validity: Capsules for 3 years.

Precautions

For chronic, recurring and severe infections or malabsorption, parenteral administration is preferred. The parenteral administration solution is best used within a few hours after the preparation of the medicinal solution. Shake well before use and inject slowly. This medicine can be added to commonly used intravenous fluids, such as normal saline, 5% glucose and 1/6 M sodium lactate. Drug rashes often occur in patients with infectious mononucleosis and lymphocytic leukemia. The combination of penicillins and cephalosporins can cause cross-allergy or cross-resistance. This drug is not suitable for subconjunctival and intrathecal injection. Occasionally, long-term use of drugs may lead to excessive growth of non-sensitive bacteria. Effects on pregnancy and lactation As far as is currently known, the use of flucloxacillin during pregnancy has not shown any danger to the fetus. Because the drug can be secreted into milk in small amounts, there is a risk of sensitization of the baby, but this risk is small.

Flucloxacillin Expert Reviews

Flucloxacillin is a semi-synthetic penicillin resistant to Staphylococcus aureus enzymes. It is mainly used in clinical treatment of various serious infections caused by enzyme-producing Staphylococcus aureus. It is also used to prevent staphylococcal infections after surgery. It is not clinically used for nail resistance. Oxicillin Staphylococcus Infection. Treatment of respiratory infections caused by Streptococcus pyogenes with flucloxacillin, the cure rate is as high as 90%. It also applies to urethral infections caused by resistant Staphylococcus aureus. ^[2]