Amoxicillin is bactericidal against non β-lactamase producing gm+ve organisms and selected gm-ve pathogens. Cloxacillin is a β-lactamase resistant penicillin active against gm+ve organisms including β-lactamase (penicillinase) producing strains of Staphylococci. It is highly active against Staph aureus, Strep pyogenes, Strep viridans and Strep pneumoniae. Also effective against penicillinase producing gonococci and against N meningitidis and H influenzae.

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GI upsets, rash, urticaria, neutropenia, neurotoxicity, agranulocytosis (rarely), increased incidence of phlebitis with IV use.

Potentially Fatal: Rarely anaphylactic shock; pseudomembranous colitis.

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Allergy to cephalosporins, infectious mononucleosis, neonates with jaundice, H/o convulsions, lactation.

Failure of OC may occur, loss of potency of cloxacillin in soln. reported with erythromycin, gentamicin, kanamycin, colistin, oxytetracycline, chlorpromazine, Vit.C, & polymyxin B sulphate. Products containing cloxacillin should not be added to IV lipids, blood products, protein hydrolysates or other proteinaceous fluids. Chloramphenicol & tetracycline antagonise bactericidal effect of penicillins. Probenecid prolongs serum drug concentration; Sulfonamides & aspirin inhibit serum protein binding of cloxacillin, thereby increasing serum-free drug levels.

Potentially Fatal: None reported.

Food Interaction
Food may delay cloxacillin absorption.

Oral
Susceptible infections
Adult: Per capsule contains amoxicillin 250 mg and cloxacillin 250 mg: 2-4 caps tid.

Parenteral
Susceptible infections
Adult: Per vial contains amoxicillin 250 mg and cloxacillin 250 mg: 1-2 vials every 6-8 hours. Dose may be given via IM/IV.
Child: Per vial contains amoxicillin 250 mg and cloxacillin 250 mg: 1 month-2 years: 0.25-0.5 vial every 6-8 hours; 2-10 years: 0.5-1 vial every 6-8 hours. Dose may be given via IM/IV.

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Caution when used during lactation

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Hypersensitivity to penicillins

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Interferes with urinary test for Bence-Jones protein. Cloxacillin also interferes with urinary 17-oxosteroids measurements.