sodium capsules and other antibacterial drugs, dicloxacillin sodium capsules should be used only to treat or prevent infections that are proven or strongly suspected to be caused by susceptible bacteria. when culture and susceptibility information are available, they should be considered in selecting or modifying antibacterial therapy. in the absence of such data, local epidemiology and susceptibility patterns may contribute to the empiric selection of therapy.

xacillin sodium, and may range in severity from mild diarrhea to fatal colitis. treatment with antibacterial agents alters the normal flora of the colon leading to overgrowth of c. difficile. c. difficile produces toxins a and b which contribute to the development of cdad. hypertoxin producing strains of c. difficile cause increased morbidity and mortality, as these infections can be refractory to antimicrobial therapy and may require colectomy. cdad must be considered in all patients who present with diarrhea following antibiotic use. careful medical history is necessary since cdad has been reported to occur over two months after the administration of antibacterial agents. if cdad is suspected or confirmed, ongoing antibiotic use not directed against c. difficile may need to be discontinued. appropriate fluid and electrolyte management, protein supplementation, antibiotic treatment of c. difficile, and surgical evaluation should be instituted as clinically indicated.

ay* in equally divided doses every 6 hours 25 mg/kg/ day* in equally divided doses every 6 hours dicloxacillin is best absorbed when taken on an empty stomach, and should be administered at least 1 hour before or 2 hours after meals. dicloxacillin should be taken with at least 4 fluid ounces (120 ml) of water and should not be taken in the supine position or immediately before going to bed (see precautions). renteral agent as soon as the clinical condition warrants.

istration and may include urticaria, pruritus, and fever. although laryngeal edema, laryngospasm, and hypotension occasionally occur, fatality is uncommon. delayed allergic reactions to penicillin therapy usually occur after 48 hours and sometimes as late as 2 to 4 weeks after initiation of therapy. manifestations of this type of reaction include serum sickness-like symptoms (ie, fever, malaise, urticaria, myalgia, arthralgia, abdominal pain) and various skin rashes. gastrointestinal reactions nausea, vomiting, diarrhea, stomatitis, black or hairy tongue, and other symptoms of gastrointestinal irritation may occur, especially during oral penicillin therapy. pseudomembranous colitis has been reported with the use of dicloxacillin. therefore, it is important to consider its diagnosis in patients who develop diarrhea in association with dicloxacillin use. reports have been received during postmarketing surveillance of esophageal burning, esophagitis, and esophageal ulceration, particularly after ingestion of dicloxacillin capsules with an insufficient quantity of water and/or before going to bed (see precautions and dosage and administration). nervous system reactions neurotoxic reactions similar to those observed with penicillin g (e.g., lethargy, confusion, twitching, multifocal myoclonus, localized or generalized epileptiform seizures) may occur with large intravenous doses of the penicillinase-resistant penicillins especially in patients with renal insufficiency. renal reactions renal tubular damage and interstitial nephritis have been associated with the administration of methicillin sodium and infrequently with the administration of nafcillin and oxacillin. manifestations of this reaction may include rash, fever, eosinophilia, hematuria, proteinuria, and renal insufficiency. methicillin-induced nephropathy does not appear to be dose-related and is generally reversible upon prompt discontinuation of therapy. hematologic reactions eosinophilia, hemolytic anemia, agranulocytosis, neutropenia, leukopenia, granulocytopenia, thrombocytopenia, and bone marrow depression have been associated with the use of penicillinase-resistant penicillins. hepatic reactions hepatotoxicity, characterized by fever, nausea, and vomiting associated with abnormal liver function tests, mainly elevated ast (sgot) levels, has been associated with the use of oxacillin and cloxacillin. cholestatic hepatitis has been reported rarely. asymptomatic, transient increases in serum concentrations of alkaline phosphatase, ast (sgot), and alt (sgpt) have been reported.

n-resistant staphylococcus aureus. routine testing of dicloxacillin is not advised. pharmacokinetics dicloxacillin sodium, usp is resistant to destruction by acid. absorption of dicloxacillin sodium after oral administration is rapid but incomplete. food in the gastrointestinal tract decreases the absorption of dicloxacillin. studies with an oral dose of 125 mg gave average serum levels at 60 minutes of 4.74 mcg/ml. at four hours, average levels were 0.62 mcg/ml. in one study, single oral doses of dicloxacillin sodium 500 mg produced peak serum concentrations of 10 to 17 mcg/ml at 1 to 1.5 hours. once absorbed, dicloxacillin sodium is 95% to 99% bound to serum proteins, mainly albumin. dicloxacillin sodium, with normal doses, has insignificant concentrations in the cerebrospinal and ascitic fluids. it is found in therapeutic concentrations in the pleural, bile, and amniotic fluids. dicloxacillin sodium is rapidly excreted as unchanged drug in the urine by glomerular filtration and active tubular secretion. the elimination half-life for dicloxacillin sodium is about 0.7 hours. dicloxacillin is not dialyzable. only minimal amounts are removed by hemodialysis or peritoneal dialysis.