Cloxacillin injectable
Injectable cloxacillin guidance for severe streptococcal and staphylococcal infections and for erysipelas or cellulitis.
Therapeutic action
Penicillin antibacterial.
Indications
- Severe infections due to streptococci and or staphylococci such as meningitis, pneumonia, omphalitis, septicaemia of cutaneous origin, endocarditis, osteomyelitis, and necrotizing skin and soft tissue infections.
- Erysipelas and cellulitis.
Forms and strengths, route of administration
- Powder for injection, in 500 mg vial, to be dissolved in 4 ml of water for injection.
- For IV infusion in 0.9% sodium chloride or 5% glucose, administered in 60 minutes.
Dose
Severe infections
- Neonate 0 to 7 days under 2 kg: 50 mg/kg every 12 hours.
- Neonate 0 to 7 days 2 kg and over: 50 mg/kg every 8 hours.
- Neonate 8 days to under 1 month under 2 kg: 50 mg/kg every 8 hours.
- Neonate 8 days to under 1 month 2 kg and over: 50 mg/kg every 6 hours.
- Child 1 month and over: 25 to 50 mg/kg, maximum 2 g, every 6 hours.
- Adult: 2 g every 6 hours.
Erysipelas, cellulitis
Dilute each dose in 5 ml/kg of 0.9% sodium chloride or 5% glucose in children less than 20 kg and in a bag of 100 ml in children 20 kg and over and in adults.
- Neonate, child, and adult: half of the severe-infection dose.
Duration
Change to oral route as soon as possible with amoxicillin/clavulanic acid or cefalexin depending on the indication. Do not use oral cloxacillin for completion treatment following parenteral therapy.
Contra-indications, adverse effects, precautions
Reconstituted solution must be used immediately.
- Do not administer to penicillin-allergic patients.
- Administer with caution to patients with allergy to cephalosporins or with renal impairment.
- May cause gastrointestinal disturbances, allergic reactions sometimes severe, and rarely haematological disorders.
- Do not combine with methotrexate.
- Pregnancy and breast-feeding: no contra-indication.
- Dicloxacillin, flucloxacillin, and oxacillin are used for the same indications.
- Do not mix with other drugs in the same infusion.
Dosage and duration
| Age | Weight | 500 mg vial (diluted in 4 ml, 125 mg/ml) | |
|---|---|---|---|
| 1 to < 3 months | 4 to < 6 kg | 1 ml x 4 | |
| 3 months to < 1 year | 6 to < 10 kg | 2 ml x 4 | |
| 1 to < 5 years | 10 to < 20 kg | 4 ml x 4 | (1 vial x 4) |
| 5 to < 8 years | 20 to < 28 kg | 8 ml x 4 | (2 vials x 4) |
| 8 to < 12 years | 28 to < 38 kg | 12 ml x 4 | (3 vials x 4) |
| ≥ 12 years and adult | ≥ 38 kg | 16 ml x 4 | (4 vials x 4) |
Source
MSF Essential drugs practical guidelines (January 2026)
This page reproduces the structured reference information for this batch while leaving out the Storage and Remarks sections.
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