Ampicillin and cloxacillin (Aspiclox)
The active ingredients of Aspiclox are Ampicillin trihydrate and Cloxacillin sodium. Each hard gelatin capsule contains Ampicillin trihydrate BP equivalent to 250 mg of Ampicillin and Cloxacillin sodium BP equivalent to 250 mg of Cloxacillin. A combination of Ampicillin and Cloxacillin is clinically effective against a wide range of gram-positive and gram-negative organism including penicillinase producing bacteria.
Both Ampicillin and Cloxacillin are acid stable and well absorbed orally, giving peak serum levels about two hours after dosing. Both components are excreted primarily by the kidneys by glomerular filtration and tubular filtration
It is indicated for the treatment of a wide range of bacterial infections caused by susceptible organisms including middle ear infections, upper and lower respiratory tract infections, gastrointestinal infections, genito-urinary tract infections and skin and soft tissue infections.
Adults and children over 10 years: 1-2 capsules (500mg to 1gm) every 6 hours. The dose can be increased depending upon the severity of the infection.
Children 2 – 10 years: 1-2 capsules (250 mg to 500 mg) every 6 hours Children up to 2 years: 250 mg every 6 hours.
Contraindicated in patients with known allergy to penicillin or cephalosporins. Cases of cross sensitivity have been reported.
When it is administered to a hypersensitive patient, anaphylactic shock with collapse and sometimes death may occur within minutes. A generalized sensitivity reaction can occur within 1 to 3 with urticarial, fever, joint pains, angioneuroticoedema, erythema multiforme and exfoliative dermatitis, although an accelerated urticarial reaction can develop within hours.
Nephrotoxicity has occurred in some patients with diminished renal function given large doses of cloxacillin and ampicillin. Disturbances of blood electrolytes may follow the administration of large doses. Some patients in the early stages of syphilis may experience a Herxheimer reaction shortly after starting treatment. Symptoms include fever, sweating, headache, malaise, and reactions at the site of lesions.
Allopurinol: Increased risk of skin rash
Antacids: May affect the efficacy of this antibiotic. Take at least 2 hours apart
Chloroquine: Reduces the efficacy of this antibiotic Oral contraceptives: Possible reduced contraceptive efficacy. Another form of oral contraceptive is advised
Probenecid: Increased risk of increased adverse effects of this antibiotic
Tetracycline: Possible reduced antibiotic efficacy
Warfarin: Increased risk of warfarin toxicity
Phenytoin: Reduced effect of Phenytoin
Pregnancy: It can be given during pregnancy. However, the drug should be used with caution.
Lactation: Although the drug can be safely given to nursing mothers, there is some risk to the baby of sensitization, skin rash and diarrhea.
Paediatric use: Because of incompletely developed renal function in new-born, penicillinase resistant penicillins may not be completely excreted, resulting in high levels of the drug.