Role of intravenous cloxacillin for inpatient infections |
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Authors: | Bru J P Garraffo R |
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Affiliation: | 1. Service des maladies infectieuses, centre hospitalier régional d’Annecy, 1, avenue de l’Hôpital, Metz-Tessy, BP 90074, 74374 Pringy cedex, France;2. Service de pharmacologie et toxicologie cliniques, faculté de médecine, hôpital Pasteur, CHU de Nice, 06002 Nice cedex 1, France |
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Abstract: | One of the issues of antibiotic treatment is to warrant its optimal effectiveness while minimizing the risk for emergence of resistance. The time above minimal inhibiting concentration (MIC) (T>MIC) is the best predictive pharmacological parameter of effectiveness for antibiotics with time-dependent activity, such as cloxacillin. Cloxacillin is the first line antibiotic in a great number of clinical situations generated by methicillin sensitive staphylococci, because of its intrinsic properties: bactericidal effect, tissue distribution and safety. The most recent anti-staphylococcal agents do not improve treatment of MSSA infections compared to penicillin M and especially cloxacillin. Cloxacillin has a narrow microbiological spectrum. This ecological feature is in line with the recommendation to use antibiotics with the narrowest spectrum to reduce the pressure of selection. The consensus is to have T>MIC for at least 40% of the dosing interval and is achieved by infusing 2g of cloxacillin per day (T>MIC=50%) or four infusions of 3g per day (T>MIC=42%) in adults. |
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Keywords: | Cloxacillin MSSA PK/PD relationship |
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