Clinical Practice Committee, Dr Lesley Voss and
- 50mg/kg/dose by slow IV injection. IM route may be used if IV access is
unavailable, but is painful and has a slower onset of action.
- Oral 25-50mg/kg/dose.
- Dosing interval as below.
- Maximum daily dose: 200mg/kg/day
- Empirical therapy for infants with
suspected coagulase negative staphylococcal sepsis but resistance is now
increasingly common. May be administered in combination with amoxycillin and
amikacin until culture results available.
- Skin and soft tissue infections.
- Bone and joint infections.
Contraindications and Precautions
- Hypersensitivity to penicillins/cephalosporins.
- Caution in preterm infants and those with jaundice, as flucloxacillin
can displace bilirubin from albumin.
- Caution in infants with liver, renal or gastrointestinal disease.
Semi-synthetic narrow spectrum
bacteriocidal antibiotic with considerable activity against penicillinase
producing coagulase negative staphylococci and Staphylococcus aureus. Has little
activity against gram negative bacilli. Action through inhibition of
biosynthesis of cell wall mucopeptides.
Well absorbed after oral
administration, although absorption is reduced in the presence of food and
unpredictable in neonates. Widely distributed at varying concentrations in human
body tissues and fluids. Very little passes into the CSF unless the meninges are
inflamed. Highly bound (92%) to human plasma proteins. Excreted, mainly
unchanged, by the kidney. Tubular excretion is inhibited by probenecid.
Possible Adverse Effects
Venous irritation, soft tissue
injury at site of IV injection.
Pain, soft tissue injury at site
of IM injection.
(nausea, vomiting, diarrhoea).
Non-specific rashes and skin
Fever, pruritus, urticaria.
Seizures (encephalopathy with high
doses greater than 400 mg/kg/day).
Hepatitis & choelstatic jaundice, possibly occurring up to several weeks after
discontinuation, has been reported occasionally in adults.
- May give concurrently with
aminoglycoside therapy for synergistic effect. Administer separately as
simultaneous administration may cause inactivation, and precipitation.
- Adjust dose in suspected significant renal
dysfunction (usually by lengthening the dosing interval).
- Give 30-60 minutes before feeds.