Flucloxacillin

[admin]

Hi

I had a funny one today. A woman brought a child (about 5) in, and gave me a script for flucloxacillin 125mg/5ml 5mls tds 150mls.

Obviously its usually 5mls qds, and as I had to use a 2nd bottle it didn't make sense to not give the full qds dose, and two full bottles (10 day course). She told me she was worried, as her child had the same infection two weeks ago, and it had returned. When I checked the computer he had also had fluclox 5mls tds 150mls then. The infection was an infected sore on the boys penis, and didn't sound very nice for the poor kid.

Does anyone think that the child was under-dosed and that caused the infection to return? He was also prescribed a 10 day course then, i.e. the same 150mls.

I rang the surgery, and the Dr agreed to change it to qds and give the child the full 200mls. I also explained to his mum about taking it on an empty stomach to improve blood levels, and hopefully cure it this time. I must admit though, that if the bacteria had a taste of fluclox 2 weeks ago, survived, and re-colonised this little boys infection I don't hold out great hope that this will actually cure it.

Any thoughts? I would have prescribed a different drug personally.

[Linnear]

Hard call.

It may be that it's nearly better so the Dr wants to kill it off with the same drug that appears to be working. I'm sure your used to parents that panic over their children and say that they're no better when a clinician can see that there is actually some improvement.

Or the doc may be worried about giving another drug to a bacterium that seems to be developing a resistance to flucloxacillin. Maybe he thinks you're gonna get a Multi-resistant strain if he gives another drug.

Or maybe he's an a*sehole!

Hope this helps!

[openmind]

The only sure-fire way to see if the fluclox is working is for the clinican to test for sensitive cultures. Long courses of fluclox are used to treat cellulitis for example.