Penicillins include-

Natural- Penicillin G, Penicillin V

Penicillase -Resistent- Cloxacillin, Docloxacillin, Methicillin, Nafacillin, Oxacillin

Aminopenicillins- Amoxicillin, Amoxicillin/Potassium Clavulanate, Ampicillin, Ampicillin/Sulbactum, Becampicillin

Extended spectrum- Carbenicilin, Mezlocillin, Piperacillin.Tazobactam sodium, Ticarcillin, Ticarcillin/Potassium clavulanate

Refer Penicillin V Potassium

 Loss of potency of cloxacillin solution reported with erythromycin, gentamycin, kanamycin, colsitin, sulpomethate sodium, oxytetracycline, chlorpromazine, Vitamin C, and polymyxin sulphate

Cloxacillin should not be added to intravenous lipids, blood products, protein hydrolysates or other proteinaceous fluid(degree of serum protein binding for Cloxacillin is 94%).

Chloramphenicol and tetracycline antagonise bactericidal effect of penicillins.

Co-administation of probenecid results in higher serum peak and prolongs serum concentration.

Sulphonamides and acetyl salicylic acid inhibit serum protein binding of cloxacillin thereby increasing free serum levels.

Gram positive infections including resistent staphylococci

 Penicillins include-

Natural- Penicillin G, Penicillin V

Penicillase -Resistent- Cloxacillin, Docloxacillin, Methicillin, Nafacillin, Oxacillin

Aminopenicillins- Amoxicillin, Amoxicillin/Potassium Clavulanate, Ampicillin, Ampicillin/Sulbactum, Becampicillin

Extended spectrum- Carbenicilin, Mezlocillin, Piperacillin.Tazobactam sodium, Ticarcillin, Ticarcillin/Potassium clavulanate

Refer Penicillin V Potassium

Rare.Hypersensitivity. Neutropenia, agranucytosis,

Neurotoxicity, rash, Increased incidence of phlebitis with IV admin,

Interferes with urinary tests for Bence-Jones proteins.

Hypersensitivity to penicillins,ocular administration, jaundice in neonates

Special precautions:

Do not add water to syrup.

Cloxacillin should not be used as topical application in eyes

Hepatic disease.

Indication-

Gram positive infections including resistent staphylococci

Dosage:

Mild to moderate upper respiratory , localised skin and soft tissue infection:

Adults and children more than 20kg - 250mg every 6hours.

Children less than 20kg: 50mg/kg/day equally divided every 6hours.

Severe infection lower respiratory tract:

Adults and children: More than 20kg - 500mg every 6hours.

Children less than 20kg- 100mg every 6 hours.

 Missed dose-

1. If you miss a dose of this medicine take it as soon as possible. This will help to keep a constant amount of medicine in the blood or urine.

2. However, if it is almost time for your next dose skip the next dose and go back to your regular dosing schedule.

3. Do not double doses.

Take on an empty stomach 1hr before or 2hr after meals