title: Role of intravenous cloxacillin for inpatient infections.
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.
authors.affiliation: Service des Maladies Infectieuses, Centre Hospitalier Régional d'Annecy, 1 Avenue de l'Hôpital, Metz-Tessy, BP 90074, 74374 Pringy Cedex, France. jpbru@ch-annecy.fr
authors.forename: J P
authors.initials: JP
authors.lastname: Bru
authors.forename: R
authors.initials: R
authors.lastname: Garraffo
mesh_terms: D000900:Anti-Bacterial Agents / Q000008:administration & dosage* / Q000494:pharmacology; D003023:Cloxacillin / Q000008:administration & dosage* / Q000494:pharmacology; D006801:Humans; D007275:Injections, Intravenous; D007297:Inpatients; D008826:Microbial Sensitivity Tests; D013203:Staphylococcal Infections / Q000188:drug therapy*; D013211:Staphylococcus aureus / Q000187:drug effects
chemical_list: D000900:Anti-Bacterial Agents; D003023:Cloxacillin