Adult

Flucloxacillin

General Information

A penicillin antibiotic. Do NOT use if patient is allergic to penicillin. 

For adult critical care areas only: Where using flucloxacillin by continuous Infusion see Adult Intensive Care Medication Guidelines

 

Formulary antimicrobial: Use in accordance with Trust guidelines 

AWaRe antibiotic classification: 'Access'. Use as per guidelines.

For all information regarding interactions, contraception, pregnancy and breastfeeding and additional information, see BNF and Summary of Product Characteristics (SPC).

Dosage

See separate guideline for Infective Endocarditis Treatment

 

Oral flucloxacillin

Intravenous flucloxacillin

Standard dose

500mg – 1g QDS

1g – 2g QDS

MSSA bacteraemia

 

2g QDS

Ambulatory treatment with elastomeric

  

4g-12g over 24 hours as per Micro/ID

 

Obesity

Dosing for penicillins should be at the upper end of recommended ranges, particularly for morbidly obese patient with severe infections, considering patient’s renal function.

Renal and hepatic impairment

Renal Impairment

eGFR (mL/min/1.73m2)

  flucloxacillin dose (oral or intravenous)

 10 or more

No adjustment

Less than 10

Max 4g daily

HD/HDF/High Flux/PD

Max 4g daily. Not dialysed

 

Hepatic impairment

No dose adjustment required.

Use with caution. The risk of flucloxacillin induced liver injury is higher in patients 50 years and over or with severe underlying disease. Hepatic events can be severe and may very rarely result in death. Onset can be delayed by up to two months. Neither route nor dose related.

Flucloxacillin is contra-indicated in patients with a previous history of flucloxacillin associated jaundice/hepatic dysfunction.

References

  1. Flucloxacillin Capsules 500 mg [online]. Manufacturer -Flamingo Pharma last updated: 22/2/22 Accessed via: www.emc.medicines.org.uk [Accessed 20/9/23].
  2. Flucloxacillin 1000 mg powder for solution for injection or infusion [online]. Manufacturer - Esteve Pharmaceuticals (formerly Intrapharm Laboratories) – last updated: 2023 May 19. Accessed via: www.emc.medicines.org.uk [Accessed 29/8/2023 ].
  3. The Renal Drug Database. Flucloxacillin - last updated: 2017 Aug 24. Accessed via: https://renaldrugdatabase.com [Accessed 29/9/2023].
  4. Habib G, et al. 2015 ESC guidelines for the management of infective endocarditis: the task force for the management of infective endocarditis of the European Society of Cardiology (ESC) endorsed by: European Association for Cardio-Thoracic Surgery (EACTS), the European Association of Nuclear Medicine (EANM). European heart journal. 2015 Nov 21;36(44):3075-128.
  5. UK Medicines Information. How should antibiotics be doses in obesity – last updated 2017 Mar 1. Accessed via: https://www.gloshospitals.nhs.uk/media/documents/Obese_Dosing_2016_update.pdf [Accessed 23/8/2023].

Editorial Information

Last reviewed: 01 Sept 2023

Next review date: 01 Sept 2026

Author(s): AMST.