Description and indication for use
Flucloxacillin
is a beta-lactamase resistant penicillin.
It is a narrow spectrum antibiotic.
It is used in the treatment of Staphylococcal and other Gram +ve
infections and when sensitivity indicates.
Dose
IV AND IM:
25 mg/kg/dose (50 mg/kg/dose may be used
for severe infections).
|
Week 1
|
12 hourly
|
|
Week 2 to 4
|
8 hourly
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Infants (>
4/52)
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6 hourly
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Reconstitution/Dilution
Vial = 500 mg (powder volume = 0.4 mL).
Vial = 1000 mg (powder volume = 0.7 mL).
For IV use:
500 mg vial – Add 4.6 mL of water for
injection = 100 mg/mL.
1000 mg vial – Add 9.3 mL of water for
injection = 100 mg/mL.
Withdraw required dose and dilute to 50 mg/mL
with sodium chloride 0.9% (can be diluted further).
For IM use:
500 mg
vial – Add 1.6 mL of water for
injection = 250 mg/mL.
Vial stable for 24 hours after
reconstitution if refrigerated.
Route and method of administration
IV:
50 mg/mL or weaker – IV push over 3 minutes.
Doses ≥ 25 mg/kg are best infused over 20-30 minutes.
Side effects
Nausea, vomiting, diarrhea.
Hypersensitivity – rash, urticaria,
eosinophilia.
Rarely – hepatitis, cholestatic jaundice.
Rarely – nephritis, haematuria.
Severe phlebitis.
Displacement of bilirubin from albumin (high
doses), therefore use with caution
in jaundiced neonates and/or premature infants.
Special precautions
CAUTION
in patients with hepatic impairment.
CAUTION in patients at risk of hyperbilirubinaemia.
Contraindications
Hypersensitivity to penicillins.
History of Flucloxacillin associated
jaundice or hepatic dysfunction.
Compatible Solutions
Sodium Chloride 0.9%.
Glucose 5%.
Glucose 5% + sodium chloride 0.9%, glucose
5% + sodium chloride 0.45%.
KCL 20 mmol/L.
Compatible Drugs
Aminophylline,
Heparin Sodium,
Digoxin, Hydrocortisone Sodium Succinate, Metronidazole, Ranitidine, Sodium Bicarbonate.
Incompatibilities
Flucloxacillin must NOT be mixed together
with the following drugs:
Amikacin, Calcium Gluconate, Ciprofloxacin,
Dobutamine, Erythromycin Lactobionate, Gentamicin, Midazolam, Morphine.
Intralipid.
Avoid giving with nutrition.
** Aminoglycosides (Amikacin, Gentamicin, Tobramycin)
are inactivated by most beta-lactam antibiotics – separate doses by 1 hour or
flush drug line well with Sodium Chloride 0.9%, before and after giving doses.
Nursing responsibilities
Careful observation of IV site.
Monitor urine output.
Separate doses if giving with aminoglycosides.