Usage
This combination medication is prescribed for the treatment of various bacterial infections, especially those caused by susceptible strains of Staphylococcus and Streptococcus. It’s commonly used for infections of the respiratory tract (e.g., pneumonia, bronchitis), skin and soft tissues, urinary tract, and ear, nose, and throat. It is not effective against viral infections.
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Pharmacological Classification: Antibiotic (amoxicillin and cloxacillin); Probiotic (Lactobacillus and Saccharomyces boulardii)
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Mechanism of Action: Amoxicillin and cloxacillin inhibit bacterial cell wall synthesis, leading to bacterial death. Lactobacillus and Saccharomyces boulardii help restore the balance of gut flora, potentially disrupted by antibiotic use. Saccharomyces boulardii also has some direct anti-infective properties.
Alternate Names
- Amoxicillin + Cloxacillin + Lactobacillus + Saccharomyces boulardii
- Moxfit CX (brand name)
- Oxfit CX (brand name)
How It Works
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Pharmacodynamics: Amoxicillin and cloxacillin exert bactericidal effects by binding to penicillin-binding proteins (PBPs) in the bacterial cell wall. This inhibits peptidoglycan synthesis, a crucial component of the bacterial cell wall, resulting in cell lysis and death. Lactobacillus and Saccharomyces boulardii help restore and maintain the gut microbial balance. Saccharomyces boulardii has anti-inflammatory and antitoxin effects within the gut.
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Pharmacokinetics:
- Absorption: Amoxicillin and cloxacillin are well-absorbed orally. Food may slightly delay but does not significantly reduce absorption.
- Metabolism: Both antibiotics are minimally metabolized.
- Elimination: Primarily renal excretion. Dosage adjustments are necessary for patients with renal impairment.
Dosage
Standard Dosage
Adults:
- Typical dosage: 250mg/250mg (amoxicillin/cloxacillin) every 6 hours.
- Dosage adjustments may be necessary based on the severity of infection and patient response.
Children:
- Dosage is weight/age-based. Consult a healthcare professional for pediatric dosing recommendations.
- This medication may not be suitable for children under 12, depending on the formulation.
Special Cases:
- Elderly Patients: Dosage adjustments may be needed based on renal function.
- Patients with Renal Impairment: Dosage reductions are necessary depending on the degree of impairment.
- Patients with Hepatic Dysfunction: Caution is advised; dosage adjustments may be needed.
- Patients with Comorbid Conditions: Exercise caution. Specific adjustments should be considered on a case-by-case basis.
Clinical Use Cases
While generally used for the conditions mentioned in the “Usage” section, specific dosing for clinical situations like intubation, surgical procedures, mechanical ventilation, ICU use, and emergency situations isn’t standardized and must be determined by the attending physician based on individual patient needs.
Dosage Adjustments
Dose modifications should be based on renal/hepatic function, age, and other patient-specific factors.
Side Effects
Common Side Effects:
- Nausea
- Vomiting
- Diarrhea
- Abdominal pain/bloating
- Indigestion
- Skin rash or itching
Rare but Serious Side Effects:
- Clostridium difficile-associated diarrhea (CDAD)
- Allergic reactions (e.g., anaphylaxis, angioedema)
- Blood dyscrasias (e.g., neutropenia, thrombocytopenia)
Long-Term Effects:
- Potential for antibiotic resistance with prolonged use.
Contraindications
- Hypersensitivity to penicillins, cephalosporins, or any component of the formulation.
- History of cholestatic jaundice or hepatic dysfunction associated with penicillin use.
Drug Interactions
- Allopurinol
- Probenecid
- Tetracyclines
- Warfarin
- Methotrexate
- Other antibiotics, antifungals, immunosuppressants
- Oral contraceptives
Pregnancy and Breastfeeding
Use with caution if clearly needed. Amoxicillin and cloxacillin are excreted in breast milk; the effects on nursing infants are unknown. Discuss risks and benefits with a healthcare professional.
Drug Profile Summary
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Mechanism of Action: Amoxicillin and cloxacillin inhibit bacterial cell wall synthesis; Lactobacillus and Saccharomyces boulardii help restore gut flora.
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Side Effects: Nausea, vomiting, diarrhea, abdominal pain, rash, itching, bloating, indigestion.
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Contraindications: Hypersensitivity to penicillins, cephalosporins.
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Drug Interactions: See “Drug Interactions” section.
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Pregnancy & Breastfeeding: Use with caution if clearly needed.
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Dosage: See “Dosage” section.
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Monitoring Parameters: Monitor for signs of allergic reactions, superinfection, or worsening of infection. Renal and liver function tests may be warranted with long-term use.
Popular Combinations
While data on specific combinations wasn’t available from the provided sources, this combination itself aims to offer synergistic benefits (antibiotic action along with gut flora support).
Precautions
- Assess for allergies, renal and hepatic function, and history of gastrointestinal disease before starting therapy.
- Complete the full course of treatment.
- For pregnant/breastfeeding women: Use only if clearly needed.
- Children and elderly: Consider age-specific precautions and dosage adjustments.
- Avoid alcohol.
FAQs (Frequently Asked Questions)
Q1: What is the recommended dosage for Amoxycillin + Cloxacillin + Lactobacillus + Saccharomyces boulardii?
A: See “Dosage” section for details.
Q2: Can this combination be used in children?
A: It depends on the specific formulation and the child’s age. Consult a healthcare professional for guidance.
Q3: What should I do if a dose is missed?
A: Take the missed dose as soon as remembered, unless it is almost time for the next dose. Do not double the dose.
Q4: Can this medication be taken with food?
A: Yes, it can be taken with food. However, avoid administering it with hot liquids.
Q5: What are the signs of an allergic reaction?
A: Watch for rashes, itching, swelling (especially of the face, throat, or tongue), and difficulty breathing. Seek immediate medical attention if these occur.
Q6: Can I drink alcohol while taking this medication?
A: It’s generally advisable to avoid alcohol during antibiotic treatment.
Q7: Should I stop taking the medication if I feel better before finishing the course?
A: No, complete the full course of antibiotics as prescribed, even if symptoms improve, to prevent recurrence and antibiotic resistance.
Q8: What are the signs of Clostridium difficile infection?
A: Watery diarrhea (often with a strong odor), fever, abdominal pain/cramping, and loss of appetite. If these occur, contact a healthcare professional immediately.
Q9: How does Saccharomyces boulardii work in this combination?
A: Saccharomyces boulardii is a yeast with probiotic properties. In this combination, it acts to restore gut flora that may be disturbed by the antibiotics, and may also have some direct anti-infective effects.
