Dicloxacillin Sodium

 Action Inhibits bacterial cell wall mucopeptide synthesis.

 Indications Treatment of infections caused by penicillinase-producing staphylococcal infection; initial therapy of suspected staphylococcal infection.

 Contraindications Hypersensitivity to penicillins.

 Route/Dosage

Adults and Children greater than 40 kg: PO 125 to 250 mg q 6 hr. Children less than 40 kg: PO 12.5 to 25 mg/kg/day divided in equal doses q 6 hr.

 Interactions

Contraceptives, oral: May reduce efficacy of oral contraceptives. Food: Antibacterial action may be reduced. Tetracyclines: May impair bactericidal effects of dicloxacillin.

 Lab Test Interferences May cause false-positive urine glucose test results with Benedict’s Solution, Fehling’s Solution, or Clinitest tablets but not with enzyme-based tests (eg, Clinistix, Tes-tape); false-positive direct Coombs’ test results in certain patient groups; false-positive protein reactions with sulfosalicylic acid and boiling test, acetic acid test, biuret reaction and nitric acid test but not with bromphenol blue test (Multistix).

 Adverse Reactions

CNS: Dizziness; fatigue; insomnia; reversible hyperactivity; seizures. DERMATOLOGIC: Urticaria; dermatitis; vesicular eruptions; erythema multiforme; rashes. EENT: Laryngospasm; laryngeal edema; itchy eyes. GI: Glossitis; stomatitis; gastritis; sore mouth or tongue; dry mouth; furry tongue; “black hairy” tongue; abnormal taste sensation; anorexia; nausea; vomiting; abdominal pain or cramps; diarrhea or bloody diarrhea; rectal bleeding; flatulence; enterocolitis; pseudomembranous colitis. GU: Interstitial nephritis (eg, oliguria, proteinuria, hematuria, hyaline casts, pyuria); nephropathy. HEMATOLOGIC: Anemias; thrombocytopenia; eosinophilia; leukopenia; granulocytopenia; neutropenia; bone marrow depression; agranulocytosis; reduced hemoglobin or hematocrit; prolonged bleeding and prothrombin time; altered lymphocyte count; increased monocytes, basophils, platelets. HEPATIC: Transient hepatitis; cholestatic jaundice. METABOLIC: Elevated serum alkaline phosphatase and hypernatremia; reduced serum potassium, albumin, total proteins and uric acid. OTHER: Hypersensitivity reactions that may lead to death; vaginitis; hyperthermia.

 Precautions

Pregnancy: Category B. Lactation: Excreted in breast milk. Hypersensitivity: Reactions range from mild to life-threatening. Administer cautiously to cephalosporin-sensitive patients because of possible crossreactivity. Superinfection: May result in bacterial or fungal overgrowth of nonsusceptible organisms. Pseudomembranous colitis: Consider possibility in patients with diarrhea.

 Administration/Storage

• Obtain specimens for culture before initiating antibiotic therapy.
• Capsules can be opened and contents mixed with small amount of food or fluid, but patient may experience bad taste.
• Give on empty stomach (30 min to 1 hr before meal or 2 hr after a meal).
• Give with full glass of water, not juice or carbonated beverage.
• If stored at room temperature, discard reconstituted oral solution after 7 days; discard after 14 days if refrigerated. Do not freeze.
• Always give in divided doses throughout day to maintain steady state.

 Assessment/Interventions

• Obtain patient history, including drug history and any known allergies.
• Assess signs of infection before and during therapy (eg, fever, vital signs, appearance of wounds, WBC).
• If signs of anaphylaxis (eg, rash, pruritus, laryngeal edema, wheezing) occur, discontinue drug and notify health care provider immediately.

 Patient/Family Education

• Instruct patient to take antibiotic on empty stomach before (30 min to 1 hr) meals or after (2 hr) meals with full glass of water.
• Explain that doses should be evenly spaced throughout day and night to maintain adequate drug levels.
• Teach patient signs of sensitivity reaction and appropriate steps to take if occuring.
• Tell patient to discard any liquid solution after 7 days when stored at room temperature or after 14 days of refrigeration.
• Instruct patient to shake bottle before measuring pediatric suspension and to use a medication cup or other calibrated device for accurate dosing.
• Teach patient signs of superinfection, which can occur with any antibiotic (eg, black, furry tongue, vaginal itching) and tell patient to notify health care provider if any occur.
• Instruct patient never to share antibiotic prescriptions with others.
• Advise patient to follow complete course of therapy, even if feeling better.

Popularity: 3% [?]

This entry was posted on Thursday, February 22nd, 2007 at 9:40 pm and is filed under Drug Facts. You can follow any responses to this entry through the RSS 2.0 feed. You can leave a response, or trackback from your own site.