Cloxacillin is indicated in the treatment of infections caused by gram-positive bacteria. It is also indicated in the treatment of infections caused by penicillinase-producing staphylococci. Such infections include:

Skin and soft tissue infections: boils, abscesses, carbuncles, furunculosis, cellulitis, infected wounds, infected burns, protection for skin grafts, various skin infections such as Ulcers, eczema and acne.

Respiratory tract, nose, ear and throat infections: pneumonia, lung abscess, empyema, sinusitis, pharyngitis, tonsillitis, quinsy, otitis media and externa.

Cloxacillin-sensitive, other bacterial infections: osteomyelitis, enteritis, endocarditis, urinary tract infection and septicemia.

Common Adult Dosage-

For food: 500 mg four times a day half to an hour before meals.

As an injection:

• As an intramuscular injection: 250 mg every four to six hours.
• As an intravenous injection: 500 mg every four to six hours. The above dose can be doubled if required.
• As an injection into the pleural cavity: 500 mg once daily.
• As an injection into the joint cavity: 500 mg once a day.

Common levels of children-

For intake: 2 to 10 years – half the adult dose. Under 2 years – one-fourth of the adult dose.

As an injection:

• For intramuscular injection: Mix 250 mg with 1.5 ml or 500 mg with 2 ml of water for injection BP.

As intravenous injection: 500 mg should be mixed with 5-10 ml of water for injection BP to dissolve. Then this solution should be applied slowly on the body for three to four minutes. Cloxacillin Injection can be mixed with any liquid suitable for infusion or administered slowly over three to four minutes in an appropriately diluted dropper tube.

As an injection into the pleural cavity: 500 mg should be mixed with 5 to 10 ml of Water for Injection BP and administered.

As an injection into the joint cavity: 500 mg should be dissolved in not more than 5 ml of water for injection BP or 0.5% lignocaine hydrochloride solution.

Cloxacillin is contraindicated in patients who are hypersensitive to penicillin.

The side effects of cloxacillin are similar to those of other penicillins. They are usually mild and transient. These side-effects include fever, diarrhoea, indigestion, rash-urticarial or erythematous. Patients with any type of rash should stop taking this medicine.

Cloxacillin should be used with caution in patients with a prior history of allergy. Cloxacillin should not be given as a subconjunctival injection or as eye drops.

Cloxacillin syrup and drops should be prepared and stored in a cool place (refrigerator if possible) immediately before use. The compounded syrup and drops should be used within five days if stored at room temperature or within seven days if refrigerated. Cloxacillin solution for intramuscular or intravenous administration should be used within 30 minutes of preparation. However, aqueous solutions of cloxacillin remain effective for up to 24 hours at room temperature (25°C).

Cloxacillin is compatible with most intravenous fluids. But never mix with non-vegetarian fluids (eg protein hydrolysates).