Cloxacillin: Brands, Price & Uses in Bangladesh

Cloxacillin is an established treatment for infections caused by penicillinase-producing Staphylococcus aureus strains that are susceptible to it, as well as for infections due to susceptible non-penicillinase-producing staphylococci and streptococci (particularly when a penicillinase-producing organism is suspected). Established uses per product labeling and clinical practice include:

• Skin and soft tissue infections (boils, abscesses, cellulitis, infected wounds and burns)
• Respiratory tract infections such as pneumonia, lung abscess, sinusitis, and otitis media caused by susceptible organisms
• Osteomyelitis and septic arthritis caused by susceptible staphylococci
• Endocarditis caused by susceptible staphylococci (usually as part of combination therapy)
• Urinary tract infections and septicemia caused by susceptible organisms

Cloxacillin may also be started empirically while awaiting culture results when a penicillinase-producing staphylococcal infection is suspected, and switched to a narrower-spectrum agent once susceptibility is confirmed. Cloxacillin is not effective against methicillin-resistant staphylococci (MRSA) or against organisms resistant by mechanisms other than penicillinase production.

The dose and route of Cloxacillin depend on the severity and site of infection, and should be determined by a qualified physician. Typical dosing ranges are summarized below; see the separate dosage, administration, pediatric_uses, and duration_of_treatment fields for further detail.

Antibiotic stewardship note: Cloxacillin should be prescribed only for infections confirmed or strongly suspected to be caused by susceptible penicillinase-producing staphylococci or other susceptible organisms. It should not be used for viral infections or for infections that do not require it, in order to reduce the risk of antibiotic resistance. Whenever possible, therapy should be guided or confirmed by culture and susceptibility testing, and the full prescribed course should be completed even if symptoms improve early, unless a physician advises otherwise.

Most side effects of Cloxacillin are mild and transient. Commonly reported effects include:

• Nausea, vomiting, epigastric discomfort, and diarrhea/loose stools
• Skin rash, urticaria (hives)

Less common but clinically important effects include:

• Hypersensitivity reactions ranging from mild rash to angioedema, wheezing, and, rarely, anaphylaxis
• Mild, usually transient elevations in liver enzymes; rarely, cholestatic hepatitis or jaundice (see precautions_and_warnings)
• Mild leukopenia or eosinophilia
• Thrombophlebitis at the site of intravenous administration
• Rarely, antibiotic-associated diarrhea, including Clostridioides difficile-associated diarrhea/colitis

Patients should seek prompt medical attention for any signs of a serious allergic reaction (difficulty breathing, swelling of the face/throat, severe rash) or signs of liver problems (yellowing of the skin or eyes, dark urine, persistent abdominal pain).