Uses
Staphylococcal Infections
Treatment of infections caused by, or suspected of being caused by, susceptible penicillinase-resistant staphylococci.
Should not be used for initial treatment of severe, life-threatening infections, including endocarditis, but may be used as follow-up after a parenteral penicillinase-resistant penicillin (nafcillin, oxacillin).
If used empirically, consider whether staphylococci resistant to penicillinase-resistant penicillins (oxacillin-resistant [methicillin-resistant] staphylococci) are prevalent in the hospital or community. (See Staphylococci Resistant to Penicillinase-resistant Penicillins under Cautions.)
Dosage and Administration
Administration
Oral Administration
Administer orally at least 1 hour before or 2 hours after meals.
Should not be used for initial treatment of severe infections and should not be relied on in patients with nausea, vomiting, gastric dilatation, cardiospasm, or intestinal hypermotility.
Dosage
Available as dicloxacillin sodium; dosage expressed in terms of dicloxacillin.
Duration of treatment depends on type and severity of infection and should be determined by the clinical and bacteriologic response of the patient. Usually continued for ≥48 hours after cultures are negative and patient becomes afebrile and asymptomatic. For severe staphylococcal infections, continue therapy for ≥14 days; more prolonged therapy is necessary for treatment of osteomyelitis, endocarditis, or other metastatic infections.
Pediatric Patients
Staphylococcal Infections
Mild to Moderate Infections
Oral
Children weighing <40 kg: 12.5 mg/kg daily given in divided doses every 6 hours.
Children weighing ≥40 kg: 125 mg every 6 hours.
Children ≥1 month of age: AAP recommends 25–50 mg/kg daily in 4 divided doses.
More Severe Infections
Oral
Children weighing <40 kg: 25 mg/kg daily given in divided doses every 6 hours; higher dosage may be necessary depending on severity of infection.
Children weighing ≥40 kg: 250 mg every 6 hours; higher dosage may be necessary depending on severity of infection.
Inappropriate for severe infections per AAP.
Acute or Chronic Osteomyelitis
Oral
50–100 mg/kg daily given in divided doses every 6 hours as follow-up to initial parenteral therapy. If an oral regimen is used, compliance must be assured and some clinicians suggest that serum bactericidal titers (SBTs) be used to monitor adequacy of therapy and adjust dosage.
When used as follow-up in treatment of acute osteomyelitis, oral regimen usually given for 3–6 weeks or until total duration of parenteral and oral therapy is ≥6 weeks; when used as follow-up in treatment of chronic osteomyelitis, oral regimen usually given for ≥1–2 months and has been given for as long as 1–2 years.
Adults
Staphylococcal Infections
Mild to Moderate Infections
Oral
125 mg every 6 hours.
More Severe Infections
Oral
250 mg every 6 hours; higher dosage may be necessary depending on severity of infection.
Special Populations
Dosage in Renal Impairment
Dosage adjustment generally unnecessary in patients with renal impairment.
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