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Antimicrobials
Cloxacillin

Cloxacillin

Medium
N/A
IV: $$ PO: $-$$

Spectrum of Activity

Antibiogram Data
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General Information

  • Brain Abscess: Ceftriaxone + Cloxacillin* + Metronidazole

  • Cutaneous Abscesses, Furuncles, Carbuncles, and Boils (Moderate, with or without cellulitis): PO (outpatient)

  • Cellulitis Without Drainable Abscess:

    • Neonate IV: (Cloxacillin + Tobramycin)
    • Infants & children: Mild (outpatients): PO Cloxacillin; Moderate-severe (inpatients): IV Cloxacillin

  • Necrotizing Fasciitis: IV: Clindamycin + Cloxacillin ± Vancomycin

  • Orbital Cellulitis: IV: Cloxacillin + Ceftriaxone + Metronidazole

  • Periorbital Cellullitis (Traumatic): Moderate-Severe: IV: Cefazolin or Cloxacillin

  • Retropharyngeal Abscess: IV: Clindamycin ± Cloxacillin

  • Dog Bite/Cat Bite: In cases where anaerobic coverage is not required, Cloxacillin + Penicillin

  • Human Bite: IV: Cloxacillin + Penicillin

  • Soil Contamination (eg, barnyard injuries): IV: Penicillin + Tobramycin + Cloxacillin

  • Septic arthritis: Neonate/infant 1-3 mos: (Cloxacillin + Tobramycin), child (Cloxacillin)

  • Osteomyelitis (acute): Neonate (Cloxacillin + Tobramycin), infant 1-3 months (Ceftriaxone + Cloxacillin), child (Cloxacillin)

  • Sickle Cell Disease: Ceftriaxone + Cloxacillin

ODB Funded (capsule, oral liquid)

  • Allergy (immediate or delayed)

  • Phlebitis at injection site in a peripheral vein

  • Cytopenias

  • Eosinophilia

  • Interstitial nephritis

  • Abnormal liver enzymes

Observe for signs and symptoms of anaphylaxis during first dose

  • Food decreases cloxacillin absorption; serum levels are reduced by ~50%

  • Management: Administer with water on an empty stomach 1 hour before or 2 hours after meals

Cloxacillin + Cefuroxime, Cloxacillin + Vancomycin are inappropriate combinations – both are efficacious vs S. aureus