Severe infections due to streptococci and/or staphylococci: meningitis, pneumonia, omphalitis, septicaemia of cutaneous origin, endocarditis, osteomyelitis, necrotizing skin and soft tissues infections, etc.
Erysipelas, cellulitis
Forms and strengths, route of administration
Powder for injection, in 500 mg vial, to be dissolved in 4 ml of water for injection, for IV infusion in 0.9% sodium chloride or 5% glucose, to be administered in 60 minutes
Dosage
Severe infections
Neonate:
0 to 7 days (< 2 kg): 50 mg/kg every 12 hours
0 to 7 days (≥ 2 kg): 50 mg/kg every 8 hours
8 days to < 1 month (< 2 kg): 50 mg/kg every 8 hours
8 days to < 1 month (≥ 2 kg): 50 mg/kg every 6 hours
Child 1 month and over: 25 to 50 mg/kg (max. 2 g) every 6 hours
Adult: 2 g every 6 hours
Age
Weight
500 mg vial
(diluted in 4 ml, 125 mg/ml)
1 to < 3 months
4 to < 6 kg
1 ml x 4
3 months to < 1 year
6 to < 10 kg
2 ml x 4
1 to < 5 years
10 to < 20 kg
4 ml x 4
(1 vial x 4)
5 to < 8 years
20 to < 28 kg
8 ml x 4
(2 vials x 4)
8 to < 12 years
28 to < 38 kg
12 ml x 4
(3 vials x 4)
≥ 12 years and adult
≥ 38 kg
16 ml x 4
(4 vials x 4)
Dilute each dose of cloxacillin in 5 ml/kg of 0.9% sodium chloride or 5% glucose in children less than 20 kg and in a bag of 100 ml of 0.9% sodium chloride or 5% glucose in children 20 kg and over and in adults.
Erysipelas, cellulitis
Neonate, child and adult: half of above dose
Duration
Change to oral route as soon as possible with amoxicillin/clavulanic acid or cefalexin depending on the indication. Do not use oral cloxacillin for completion treatment following parenteral therapy.
Contra-indications, adverse effects, precautions
Do not administer to penicillin-allergic patients.
Administer with caution to patients with allergy to cephalosporins (cross-sensitivity may occur) or with renal impairment (reduce the dose).
May cause: gastrointestinal disturbances (particularly diarrhoea), allergic reactions sometimes severe; rarely,haematological disorders.
Do not combine with methotrexate (increased methotrexate toxicity).
Pregnancy and breast-feeding: no contra-indication
Remarks
Dicloxacillin, flucloxacillin and oxacillin are used for the same indications. Do not mix with other drugs in the same infusion.