Description
Perpen® is an isoxazolyl penicillin of the beta-lactam group of antibiotics, which exerts a bactericidal effect upon many Gram-positive organisms including streptococci, clostridia and neisseria and beta-lactamase producing staphylococci. It is not inactivated by hydrolysis due to penicillinase enzyme and is stable to gastric acid. Flucloxacillin kills bacteria by interfering the synthesis of the bacterial cell wall. Flucloxacillin binds to penicillin-binding proteins (PBPs) on the bacterial cell wall, thus interfering the synthesis of Peptidoglycan, a building block material of Bacterial cell wall. Due to this interference, the cell wall becomes weakened and then ruptured. The penicillinase resistant activity is probably related with the steric hindrance induced by the acyl side chain which prevents the opening of the ß-lactam ring.
Indication
Perpen® is indicated for the treatment of infections due to Gram-positive organisms, including infections caused by ß-lactamase producing staphylococci.
Dosage and Administration
Adult: The usual adult dose is 250mg 6 hourly. In severe infections, the dose may be doubled to 500mg 6 hourly.
Children 2-10 years: Half of the adult dose.
Children Under 2 Years: Quarter of the adult dose.
Osteomyelitis, endocarditis: Up to 8 gm daily, in divided doses six to eight hourly.
Doses should be administered half to one hour before meals.
Pregnancy
Animal studies with Flucloxacillin have shown no teratogenic effects. Limited information is available concerning the results of the use of Flucloxacillin in human pregnancy. Therefore the use of Flucloxacillin in pregnancy should be reserved for cases considered essential by physicians.
Lactation
Trace quantities of Flucloxacillin are excreted in breast milk. Flucloxacillin may be administered during the period of lactation. With the exception of the risk of sensitization, there are no detrimental effects for the breastfed infant.
Side effect
Side effects are usually uncommon and mild and transitory in nature. Minor gastrointestinal disturbances, such as nausea, diarrhoea, may occur during treatment. If hypersensitivity reactions e.g. skin rash & urticaria occur, treatment should be discontinued. Hepatic and cholestatic jaundice have been reported rarely. Changes in Liver Function Test results may occur, but are reversible when treatment is discontinued. Pseudomembranous colitis is very uncommon and usually has been associated with the use of Flucloxacillin in combination with other antibiotics.
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