From the Guidelines
The recommended dose of Cloxacillin for adults is not explicitly stated in the provided evidence, but for pediatric patients, the dosage is 50 mg kg−1 QDS (four times daily) for various conditions such as mastoiditis, osteomyelitis, and pneumonia when a staphylococcal infection is suspected, as per the guidelines 1.
Dosage Considerations
- For pediatric patients, the dosage is weight-based, with a recommended dose of 50 mg kg−1 QDS for conditions like mastoiditis, osteomyelitis, and pneumonia when a staphylococcal infection is suspected 1.
- The duration of treatment depends on the infection being treated, but the evidence provided does not specify the exact duration for cloxacillin treatment.
- It is essential to note that the evidence provided does not give explicit dosage recommendations for adults, but it does provide guidelines for pediatric patients.
Administration and Precautions
- Although not explicitly stated in the provided evidence, it is generally recommended to take cloxacillin on an empty stomach, 1 hour before or 2 hours after meals, with a full glass of water to enhance absorption.
- Patients with a history of penicillin allergy should exercise caution due to potential cross-reactivity, and renal dosing adjustments may be necessary for patients with kidney impairment, but these considerations are not directly addressed in the provided evidence 1.
Key Points
- The provided evidence focuses on pediatric dosages, with 50 mg kg−1 QDS being the recommended dose for various conditions 1.
- The evidence does not provide explicit dosage recommendations for adults or detailed administration instructions for cloxacillin.
- It is crucial to consult up-to-date guidelines and medical professionals for specific dosage recommendations and administration instructions tailored to individual patient needs.
From the FDA Drug Label
DOSAGE AND ADMINISTRATION ... RECOMMENDED DOSAGES FOR DICLOXACILLIN SODIUM, USP IN MILD TO MODERATE AND SEVERE INFECTIONS ... The FDA drug label does not answer the question.
From the Research
Cloxacillin Dose for Adults and Pediatric Patients
The recommended dose of Cloxacillin varies depending on the patient's condition and renal function.
- For adults with infective endocarditis, the recommended dose is 12 g per day, regardless of patient characteristics 2.
- However, a study suggests that this dose may lead to overdosing in patients with renal impairment, and a dosing nomogram should be used to determine the optimal daily dose based on renal function 2, 3.
- The nomogram recommends a daily dose ranging from 3.5 to 13.1 g for a glomerular filtration rate (GFR) ranging from 20 to 125 mL/min 2.
- For severe infections treated in ICU, the suggested dose of 12 g/day for cloxacillin treatment may result in overdosing, and doses should be accurately monitored and reduced, particularly when renal replacement therapy is needed 3.
- Another study recommends infusing 2g of cloxacillin per day (T>MIC=50%) or four infusions of 3g per day (T>MIC=42%) in adults to achieve the desired pharmacological parameter of effectiveness 4.
- There is no specific information available on the recommended dose of Cloxacillin for pediatric patients in the provided studies.
- However, it is essential to consider the interindividual pharmacokinetic variability of plasma concentrations of cloxacillin administered in high doses intravenously in critically ill patients, related to renal function or administration method 5.