|Pronunciation||dye klox' a sil' in|
|Drug class||Antibiotic (penicillin)|
|Main uses||Staphylococcal infections|
|Side effects||Nausea, diarrhea, rash, allergic reactions|
|Typical dose||125 to 500 mg QID|
|Bioavailability||60 to 80%|
|Elimination half-life||0.7 hours|
|Excretion||Kidney and biliary|
|Chemical and physical data|
|Molar mass||470.32 g·mol−1|
|3D model (JSmol)|
Dicloxacillin is an antibiotics used to treat Staphylococcal infections. This may include cellulitis, osteomyelitis, and pneumonia. While it is effective in penicillinase resistant disease it not effective for MRSA. It is taken by mouth.
Common side effects include nausea, diarrhea, rash, and allergic reactions. Other side effects may include anaphylaxis, Clostridium difficile diarrhea and low white blood cells. Use in pregnancy appears to be relatively safe, but has not been well studied. It is a β-lactam antibiotic and penicillin. It works by interfering with the bacterial cell wall.
Dicloxacillin is used to treat mild-to-moderate staphylococcal infections. To decrease the development of resistance, dicloxacillin is recommended to treat infections that are suspected or proven to be caused by beta-lactamase-producing bacteria.
Dicloxacillin is similar in pharmacokinetics, antibacterial activity, and indications to flucloxacillin, and the two agents are considered interchangeable. It is believed to have lower incidence of severe live adverse effects than flucloxacillin, but a higher incidence of renal adverse effects.
Dicloxacillin is used for the treatment of infections caused by susceptible bacteria. Specific approved indications include:
- Staphylococcal skin infections and cellulitis – including impetigo, otitis externa, folliculitis, boils, carbuncles, and mastitis
- Pneumonia (adjunct)
- Osteomyelitis, septic arthritis, throat infections, streptococcus
- Empirical treatment for endocarditis
- Surgical prophylaxis
It is typically taken at a dose of 125 to 500 mg every 6 hours.
Common adverse drug reactions (ADRs) associated with the use of dicloxacillin include: diarrhoea, nausea, rash, urticaria, pain and inflammation at injection site, superinfection (including candidiasis), allergy, and transient increases in liver enzymes and bilirubin.
On rare occasions, cholestatic jaundice (also referred to as cholestatic hepatitis) has been associated with dicloxacillin therapy. The reaction may occur up to several weeks after treatment has stopped, and takes weeks to resolve. The estimated incidence is 1 in 15,000 exposures, and is more frequent in people over 55 years old, females, and those with treatment longer than 2 weeks.
Dicloxacillin can also lower the effectiveness of birth control pills and pass into breast milk.
Dicloxacillin has potential interactions with following drugs:
Despite dicloxacillin being insensitive to beta-lactamases, some organisms have developed resistance to other narrow-spectrum β-lactam antibiotics including methicillin. Such organisms include methicillin-resistant Staphylococcus aureus (MRSA).[better source needed]
Mechanism of action
Like other β-lactam antibiotics, dicloxacillin acts by inhibiting the synthesis of bacterial cell walls. It inhibits cross-linkage between the linear peptidoglycan polymer chains that make up a major component of the cell wall of Gram-positive bacteria.
Dicloxacillin is insensitive to beta-lactamase (also known as penicillinase) enzymes secreted by many penicillin-resistant bacteria. The presence of the isoxazolyl group on the side chain of the penicillin nucleus facilitates the β-lactamase resistance, since they are relatively intolerant of side-chain steric hindrance. Thus, it is able to bind to penicillin-binding proteins (PBPs) and inhibit peptidoglycan crosslinking, but is not bound by or inactivated by β-lactamase
Society and culture
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