A-FLOX 500 MG

Description

Indications

A-Flox is prescribed for the treatment of infections caused by Gram-positive bacteria, including penicillinase-producing Staphylococcus strains. It is effective in treating the following conditions:

• Skin and Soft Tissue Infections: Boils, abscesses, carbuncles, infected skin conditions such as ulcers, eczema, acne, furunculosis, cellulitis, infected wounds, burns, otitis media and externa, and impetigo.
• Respiratory Tract Infections: Pneumonia, lung abscess, empyema, sinusitis, pharyngitis, tonsillitis, and quinsy.
• Other Infections: Osteomyelitis, enteritis, endocarditis, urinary tract infections, meningitis, and septicemia caused by A-Flox-sensitive organisms.
• Surgical Prophylaxis: Used as a preventive measure during major surgical procedures such as cardiothoracic and orthopedic surgeries.

Use this medication only under the supervision of a registered physician.

Pharmacology

Flucloxacillin is an antibiotic that primarily targets Gram-positive bacteria, including penicillinase-producing strains. It has minimal activity against Gram-negative bacteria. As an isoxazolyl penicillin, Flucloxacillin is resistant to degradation by penicillinase and remains stable in gastric acid.

Flucloxacillin works by inhibiting bacterial cell wall formation, which is essential for bacterial survival. It specifically interferes with peptidoglycan synthesis, a critical structural component of the bacterial cell wall. By inhibiting the transpeptidase enzyme responsible for cross-linking peptidoglycan chains, Flucloxacillin weakens the bacterial cell wall, ultimately leading to cell rupture and bacterial death. Its resistance to penicillinase is attributed to the steric hindrance created by its acyl side chain, which prevents the enzymatic breakdown of its β-lactam ring.

Dosage and Administration

Oral Administration

• Adults: 250 mg four times daily; in severe infections, the dose may be doubled. In cases such as osteomyelitis and endocarditis, doses up to 8 g daily may be administered in divided doses every 6-8 hours.
• Children (2-10 years): Half of the adult dose.
• Children (Under 2 years): One-quarter of the adult dose.

Parenteral Administration

• Adults/Elderly:
  • Intramuscular Injection: 250 mg four times daily.
  • Intravenous Injection: 250 mg to 1 g four times daily, administered slowly over 3-4 minutes or via intravenous infusion.
  • For severe infections (e.g., osteomyelitis, endocarditis), the total daily dose may be increased up to 8 g.
• Children:
  • 2-10 years: Half of the adult dose.
  • Under 2 years: One-quarter of the adult dose.

Oral doses should be taken at least one hour before meals for optimal absorption.

Drug Interactions

Concurrent use of A-Flox with certain medications may lead to prolonged elevated levels of Flucloxacillin in the bloodstream. Always consult a healthcare professional before combining it with other drugs.

Contraindications

A-Flox is contraindicated in individuals with known hypersensitivity to penicillins.

Side Effects

Common side effects may include:

• Gastrointestinal Disturbances: Nausea, vomiting, diarrhea, dyspepsia, and other minor digestive issues.
• Allergic Reactions: Rashes, urticaria, purpura, fever, interstitial nephritis.
• Hepatic Effects: Hepatitis and cholestatic jaundice have been reported in some cases.

Use During Pregnancy & Lactation

• Pregnancy: Classified as a Category B drug by the US FDA. While there are no well-controlled studies in pregnant women, animal studies do not indicate direct fetal harm. Use during pregnancy should be limited to cases where the benefits outweigh potential risks.
• Lactation: Flucloxacillin is excreted in breast milk. Caution is advised when administering this medication to breastfeeding mothers.

Precautions & Warnings

• Use with caution in patients with liver disease or hepatic dysfunction.
• Individuals with a history of allergic reactions should take extra precautions.

Use in Special Populations

For patients with severe renal impairment (creatinine clearance <10 ml/min), dose adjustments or extended dosing intervals may be required.

Therapeutic Class

Penicillinase-resistant penicillins.

Reconstitution & Alternative Administration

• For intraarticular administration: 250-500 mg daily, dissolved in a 0.5% lignocaine hydrochloride solution if necessary.
• For intrapleural injection: 250 mg daily.
• For nebulizer use: 125-250 mg dissolved in 3 ml of sterile water, administered four times daily.

Storage Conditions

• Store in a dry place, away from direct light and heat.
• Keep out of reach of children.