Flucloxacillin & Liver Disease

Dieter Fellner · Dec 24, 2006

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Conclusions

Flucloxacillin is now established as an important cause of cholestatic liver disease. Warnings about the risk have not had an impact on prescribing practices in the UK, where it remains the predominantly prescribed antistaphylococcal oral antibiotic. This situation in the UK is in sharp contrast to regulatory actions and changes in prescribing habits in Australia after identification of the risk of cholestasis associated with flucloxacillin,
and to the predominant use of the alternative drug dicloxacillin in the U SA.
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I am not aware there has been any publicity about this in the UK and it is a common antibiotic used in my department. Any feedback ?

From the British National Formulary

CSM advice (hepatic disorders)
CSM has advised that very rarely cholestatic jaundice and hepatitis may occur up to several weeks after treatment with flucloxacillin has been stopped. Administration for more than 2 weeks and increasing age are risk factors. CSM has reminded that:

flucloxacillin should not be used in patients with a history of hepatic dysfunction associated with flucloxacillin;

flucloxacillin should be used with caution in patients with hepatic impairment;

careful enquiry should be made about hypersensitivity reactions to beta-lactam antibacterials.
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Tuckersm · Dec 27, 2006

Flulclox went out of favour in Australia about 10 years ago following the initial publication of this Australian research, but has now crept back into fairly common usage, as almost all antibiotics have some sort of hepatic effect and it can be the best drug for a number of lower limb infections for those with out liver disease.

Dieter Fellner · Jan 11, 2007

Tuckersm said:

Flulclox went out of favour in Australia about 10 years ago following the initial publication of this Australian research, but has now crept back into fairly common usage, as almost all antibiotics have some sort of hepatic effect and it can be the best drug for a number of lower limb infections for those with out liver disease.
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Stephen - thank you for this insight.

Flucloxacillin & Liver Disease

Dieter Fellner Well-Known Member

Attached Files:

FCXLN.pdf

Tuckersm Well-Known Member

Dieter Fellner Well-Known Member

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Flucloxacillin & Liver Disease

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