Oral Infections caused by susceptible penicillinase-producing staphylococci
Adult: For mild to moderate cases: 125 mg 6 hourly. For severe cases: 250 mg 6 hourly. Dosage and treatment recommendations may vary among countries and between individual products (refer to local or specific product guidelines). Child: In patients weighing <40 kg: For mild to moderate cases: 12.5 mg/kg daily in equally divided doses 6 hourly. For severe cases: 25 mg/kg daily in equally divided doses 6 hourly. Dosage and treatment recommendations may vary among countries and between individual products (refer to local or specific product guidelines).
Administration
Dicloxacillin Should be taken on an empty stomach.
Contraindications
Hypersensitivity to dicloxacillin or any other penicillin.
Special Precautions
Patient with history of significant allergies and/or asthma. Children. Pregnancy and lactation.
Adverse Reactions
Significant: Fungal or bacterial superinfection (prolonged use). Rarely, oesophageal burning or ulceration and oesophagitis (particularly after administration with insufficient water and before going to bed). Blood and lymphatic system disorders: Eosinophilia, agranulocytosis, neutropenia, haemolytic anaemia, leucopenia, thrombocytopenia, granulocytopenia. Gastrointestinal disorders: Nausea, vomiting, diarrhoea, stomatitis, black or hairy tongue. Hepatobiliary disorders: Hepatotoxicity. Rarely, cholestatic hepatitis. Investigations: Asymptomatic transient increases in serum alkaline phosphatase, AST and ALT. Renal and urinary disorders: Renal insufficiency, renal tubular disease, interstitial nephritis. Potentially Fatal: Serious hypersensitivity reactions (e.g. anaphylactic shock with collapse); Clostridioides difficile-associated diarrhoea.
Monitoring Parameters
Perform culture and susceptibility tests; consult local institutional recommendations before treatment initiation due to antibiotic resistance risks. Monitor urinalysis, BUN, serum creatinine, AST and ALT periodically during treatment (particularly during prolonged use). Obtain CBC with differential at baseline and then periodically. Assess for signs and symptoms of anaphylaxis during the initial dose.
Drug Interactions
May antagonise bactericidal effect with tetracycline. Increased and prolonged serum concentration with probenecid. May diminish the anticoagulant effect of warfarin and dicoumarol.
Food Interaction
Reduced absorption with food.
Lab Interference
May cause false-positive results for urine and serum proteins, uric acid and urinary steroids. May interfere with urinary glucose tests that use cupric sulfate (e.g. Benedict's solution, Clinitest®).
Action
Description: Mechanism of Action: Dicloxacillin is an isoxazolyl penicillinase-resistant penicillin that exerts a bactericidal action. It inhibits bacterial cell wall synthesis by binding to 1 or more penicillin-binding proteins (PBPs), thereby blocking the final transpeptidation step of peptidoglycan synthesis. This action ultimately leads to bacterial lysis. Pharmacokinetics: Absorption: Rapidly but incompletely absorbed from the gastrointestinal tract. Reduced absorption with food. Bioavailability: 49-76%. Time to peak plasma concentration: 0.5-2 hours. Distribution: Distributed in bone, body tissues and body fluids. Low CSF penetration. Crosses the placenta and enters breast milk. Volume of distribution: 5.99 L. Plasma protein binding: 95-99%, mainly to albumin. Metabolism: Partially metabolised into active and inactive metabolites. Excretion: Via urine (31-65% as unchanged drug and active metabolite); faeces. Elimination half-life: Approx 0.7 hours.
Chemical Structure
Dicloxacillin Source: National Center for Biotechnology Information. PubChem Compound Summary for CID 18381, Dicloxacillin. https://pubchem.ncbi.nlm.nih.gov/compound/Dicloxacillin. Accessed Aug. 26, 2025.
J01CF01 - dicloxacillin ; Belongs to the class of beta-lactamase resistant penicillins. Used in the systemic treatment of infections.
References
Brayfield A, Cadart C (eds). Dicloxacillin. Martindale: The Complete Drug Reference [online]. London. Pharmaceutical Press. https://www.medicinescomplete.com. Accessed 01/07/2025.Dicloxacillin Sodium Capsule (Aurobindo Pharma Limited). DailyMed. Source: U.S. National Library of Medicine. https://dailymed.nlm.nih.gov/dailymed. Accessed 01/07/2025.Dicloxacillin Sodium. UpToDate Lexidrug, AHFS DI (Adult and Pediatric) Online. American Society of Health-System Pharmacists, Inc. Waltham, MA. UpToDate, Inc. https://online.lexi.com. Accessed 01/07/2025.Dicloxacillin. UpToDate Lexidrug, Lexi-Drugs Multinational Online. Waltham, MA. UpToDate, Inc. https://online.lexi.com. Accessed 01/07/2025.
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