A-Flox 250 mg/vial IM/IV Injection

A-Flox 250 mg/vial IM/IV Injection (Flucloxacillin) — Product Overview

What is A-Flox Injection (Flucloxacillin IV/IM)?

A-Flox Injection contains Flucloxacillin Sodium as a sterile powder for reconstitution and parenteral (IV or IM) administration. It provides the same penicillinase-resistant anti-staphylococcal action as oral A-Flox capsules but achieves much higher plasma levels immediately — essential for severe or life-threatening staphylococcal infections that cannot wait for oral therapy. The injection is used in hospital settings for serious infections including staphylococcal septicaemia, endocarditis, osteomyelitis, and severe skin infections requiring parenteral antibiotics.

When is IV/IM Flucloxacillin Needed?

Parenteral flucloxacillin is indicated when:

• The infection is severe or rapidly spreading (cellulitis with systemic features, septicaemia)
• Oral medication is not possible (vomiting, surgery, altered consciousness)
• Deep-seated infections require high blood levels not achievable orally (endocarditis, osteomyelitis)
• Initial rapid treatment is needed before step-down to oral therapy

Indications

• Staphylococcal septicaemia (bloodstream infection)
• Infective endocarditis — IV flucloxacillin is first-line for native valve staphylococcal endocarditis
• Osteomyelitis — IV initial therapy, then step down to oral
• Septic arthritis
• Severe cellulitis / necrotising fasciitis (component of therapy)
• Severe diabetic foot infections with systemic features
• Staphylococcal pneumonia
• Post-operative wound infections requiring parenteral therapy

Dosage — Parenteral

Adults:

• IM: 250–500 mg every 6 hours
• IV bolus/infusion: 250 mg–2 g every 6 hours depending on severity
• Endocarditis/osteomyelitis: 2 g IV every 6 hours (8 g/day)

Children: 12.5–50 mg/kg every 6 hours IV depending on severity.

Reconstitution for IM: Dissolve in 1.5 ml Water for Injection. Give deep IM into large muscle. IM injections are painful — IV route preferred for prolonged therapy.

Reconstitution for IV bolus: Dissolve in 5–10 ml Water for Injection; give over 3–4 minutes.

Reconstitution for IV infusion: Add to 50–100 ml Normal Saline or 5% Dextrose; infuse over 30–60 minutes. Use within 1 hour of preparation.

Contraindications

• Penicillin hypersensitivity / anaphylactic reaction to any beta-lactam
• History of flucloxacillin-associated hepatic dysfunction or jaundice

Side Effects

Local (injection site): Pain and tenderness at IM site; phlebitis with IV infusion — use large veins and rotate sites.

Systemic: Same profile as oral flucloxacillin — GI upset (less relevant parenterally), rash, elevated liver enzymes.

Rare but serious: Anaphylaxis (requires immediate emergency treatment), cholestatic hepatitis (monitor LFTs on prolonged courses), pseudomembranous colitis.

Warfarin interaction: IV flucloxacillin strongly reduces INR — monitor daily in anticoagulated patients.

Frequently Asked Questions (FAQ)

Q: When is IV flucloxacillin used instead of oral?
A: IV flucloxacillin is used for severe or deep-seated infections (endocarditis, osteomyelitis, septicaemia), when the patient cannot take oral medication, or when high blood levels are needed rapidly. Once the patient improves, treatment is typically stepped down to oral flucloxacillin capsules.

Q: Is IV flucloxacillin effective for MRSA?
A: No. Flucloxacillin is not effective against MRSA (methicillin-resistant Staphylococcus aureus). MRSA requires different antibiotics (vancomycin, linezolid, or daptomycin). Flucloxacillin treats only MSSA (methicillin-sensitive S. aureus).

Q: Can A-Flox injection be mixed with other IV drugs?
A: Generally, do not mix flucloxacillin with other medications in the same syringe or infusion bag unless compatibility is confirmed. Give through a separate IV line or flush well between medications.

Q: How quickly does IV flucloxacillin work?
A: Therapeutic blood levels are achieved within minutes of IV administration. Clinical improvement in severe cellulitis is typically seen within 24–48 hours of starting IV therapy.

Medical Disclaimer

For educational purposes only. Parenteral flucloxacillin must be administered by trained healthcare professionals in appropriate clinical settings. Monitor for anaphylaxis during the first 30 minutes of administration. Report jaundice at any time during or after treatment.