Dicloxacillin (Betaclox) is a penicillin antibiotic of the beta-lactam group. It has a narrow spectrum of activity and is used in the treatment of patients with infections caused by staphylococcus aureus.

Dicloxacillin Uses:

• Staphylococcal infections:
  • Treatment of infections brought by by staphylococci that produce penicillinase.
• Off Label Use of Dicloxacillin in Adults:
  • Bite wounds caused by animal bites.
  • Impetigo

Dicloxacillin (Betaclox) Dose in Adults:

Dicloxacillin (Betaclox) Dose in the treatment of Staphylococcal infections:

• Oral: 125 to 250 mg every 6 hours

Dicloxacillin (Betaclox) Dose in the treatment of Bite wounds (animal) (off-label):

• Oral: 4 times a day, 500 mg, with penicillin

Dicloxacillin (Betaclox) Dose in the treatment of Impetigo (off-label):

• Oral: Depending on how the treatment responds, take 250 mg four times each day for seven days.

Dicloxacillin (Betaclox) Dose in the treatment of prosthetic joint infection:

• Chronic suppression therapy:
  • Staphylococci (oxacillin-susceptible) (off-label dose):
    • Oral: 500 mg each six to eight hours.

Dicloxacillin (Betaclox) Dose in the treatment of Skin and soft tissue infection due to MSSA (off-label dose):

• Oral: For one to two weeks, take 500 mg every six hours.

Dicloxacillin (Betaclox) Dose in Children:

General dosing in susceptible infection:

• Infants, Children, and Adolescents:
  • Mild to moderate infection:
    • Oral: Divided every six hours, 12 to 25 mg/kg/day
    • maximum dose: 250 mg per dose
  • Severe infection (step-down therapy of bone and joint infection):
    • Oral: Every six hours, 100 mg/kg per day; the maximum dose is 500 mg per dose

Dicloxacillin (Betaclox) Dose in the treatment of Skin and soft tissue infection caused by methicillin-susceptible Staphylococcus aureus (MSSA):

• Infants, Children, and Adolescents:
  • Oral: The maximum dose is 500 mg per dose, divided over 25 to 50 mg/kg/day every six hours.

Pregnancy Risk Factor B

• Animal reproductive studies have shown unpleasing effects.
• Dicloxacillin is introduced to the placenta.
• Penicillins given to mothers have not been shown to increase the risk of birth abnormalities.

Use during breastfeeding:

• Breast milk contains dicloxacillin.
• Antibiotics found in breast milk can alter the intestinal flora without changing the dose.
• The manufacturer warns against giving dicloxacillin breastfeeding women.
• However, penicillins can be used in the recommended doses and are compatible with breastfeeding.
• Dicloxacillin is a treatment for mastitis in lactating mothers.

Dose in Kidney Disease:

The manufacturer's labelling does not specify any dosage changes; overall dosage decrease should be taken into account in cases of kidney impairment.

• Hemodialysis:
  • Not dialyzable;
  • An additional dose is not needed.
• Peritoneal dialysis effects:
  • An additional dose is not needed.

Dose in Liver disease:

Manufacturer's labeling provides no dosage modifications.   

Side Effects of Dicloxacillin (Betaclox):

• Gastrointestinal:
  • Abdominal pain diarrhea
  • Nausea

Contraindications to Dicloxacillin (Betaclox):

Hypersensitivity to penicillins and dicloxacillin or any other penicillins or any component of this formulation

Warnings and precautions

• Hypersensitivity reactions
  • Patients receiving penicillin therapy have experienced severe and sometimes fatal allergic reactions (anaphylactic stress with collapse).
  • Only start treatment after you have done a thorough background check on the drug and allergy.
  • Patients with severe allergies or asthma should be cautious.
  • If you experience an allergic reaction, stop using the medication and seek appropriate treatment.
• Superinfection
  • Extended use of antibiotics has been connected with significant bacterial and fungal infections, such as C. difficile-associated diarrhoea (CDAD) and pseudomembranous collitis (Pseudomembranous Colitis).
  • Even after antibiotic treatment, CDAD was still present.

Dicloxacillin: Drug Interaction

Note: Drug Interaction Categories:

• Risk Factor C: Monitor When Using Combination
• Risk Factor D: Consider Treatment Modification
• Risk Factor X: Avoid Concomitant Use

Monitoring parameters:

• Baseline and periodic CBC with differential;
• periodic BUN, serum creatinine,
• AST and ALT (especially with prolonged therapy);
• Prothrombin time if patient concurrently on warfarin;
• Signs of anaphylaxis during the first dose

How to administer Dicloxacillin (Betaclox)?

Oral:

• Give with at least 120 mL of water one hour before or two hours after meals.
• Give your all to encourage less fluctuation in serum levels at the peak and trough.
• Should not be administered in the supine position or immediately before going to bed.   

Mechanism of action of Dicloxacillin (Betaclox):

• Inhibits the development of bacterial cell walls by interacting with one or more penicillin-binding proteins.
• This, in turn, prevents the last stage of peptidoglycan formation in the walls of bacterial cells.
• Bacteria eventually lyse as a result of cell wall hydrolases' (autolysins, murein hydrolases) ongoing activity, while cell wall synthesis stops.

Absorption:

• Rapid and incomplete;
• Reduced by food

Distribution:

• Increased in patients with ESRD on IHD;
• CSF penetration is low

Protein binding:

• 95% to 99% (primarily albumin)

Bioavailability:

• 49% to 76%.

Half-life elimination:

• ~0.7 hours;
• prolonged with renal impairment.

Time to peak, serum:

• 1 to 1.5 hours

Excretion:

• Feces;
• urine (as unchanged drug);
• CF patients: More rapid excretion than healthy patients.

International Brand Names of Dicloxacillin:

• Betaclox
• Brispen
• Butimaxil
• Damacir
• Diamsalina
• Diclex
• Diclo
• Diclocil
• Diclonox
• Diclox
• Dicloxane
• Dicloxane-F
• Dicloxin
• Dicloxno
• Dicloxsig
• Diloxin
• Distaph
• Ditterolina
• Dyclobiot
• Hilox
• Penclox
• Posipen
• Uniclox
• Ziefmycin

Dicloxacillin Brand Names in Pakistan:

No Brands Available in Pakistan.