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Dicloxacillin is a penicillinase‑resistant penicillin used for infections due to methicillin‑susceptible Staphylococcus aureus (MSSA).
Administer on an empty stomach every 6 hours; food reduces peak concentrations and compromises time-above-MIC goals for MSSA.
Rotate to dicloxacillin only after susceptibility data exclude MRSA, as the agent lacks activity against resistant staphylococci, enterococci, and anaerobes.
Monitor hepatic function, gastrointestinal tolerance, and potential drug-drug interactions (e.g., warfarin) during courses that extend beyond 7–10 days, and review beta-lactam allergy history before initiation.
Dicloxacillin is a penicillinase-resistant oral penicillin used for methicillin-susceptible Staphylococcus aureus (MSSA) infections when culture-directed therapy is required.
Prioritize use for confirmed or strongly suspected MSSA skin/soft tissue infections, and transition to oral dicloxacillin only when adherence to q6h dosing is realistic.
| Condition | Age Range | First Line? | Notes |
|---|---|---|---|
| MSSA impetigo or folliculitis requiring systemic therapy | Children and adolescents | Yes | Preferred oral agent when cultures confirm penicillinase-producing MSSA and adherence to q6h dosing is feasible. |
| MSSA cellulitis (nonpurulent or post-incision and drainage adjunct) | Children and adolescents | Yes | Use when streptococcal coverage is needed and MRSA risk is low; ensure reliable q6h dosing or consider cephalexin. |
| Step-down therapy for MSSA osteomyelitis or bacteremia after IV treatment | Children (specialist oversight) | No | Specialist-guided; confirm susceptibility and ensure close monitoring for adherence and hepatic adverse effects. |
| MSSA pneumonia or other invasive MSSA infections when oral therapy is appropriate | No | Use only when organism is confirmed susceptible and patient is clinically stable. | |
| Postoperative prophylaxis for MSSA colonization (selected orthopedic cases) | No | Surgeon-directed, short-course prophylaxis when MRSA risk is low. |
FDA-approved primary uses with Level A evidence
Quick selection guides and diagnostic pearls
When to consider other medications
How to explain treatment to families
Dicloxacillin is usually well tolerated but can cause gastrointestinal upset, rash, and rarely hepatic or hematologic complications. Early recognition of allergy is critical.
Monitor for diarrhea (including C. difficile), signs of hypersensitivity, and hepatic dysfunction during prolonged therapy. Counsel families to complete courses to reduce resistance risk.
Nausea, vomiting, abdominal discomfort
Common • mild
Diarrhea / C. difficile infection
Uncommon • moderate to severe
Maculopapular rash
Common • mild
Immediate hypersensitivity (urticaria, angioedema, anaphylaxis)
Rare • severe
Cholestatic hepatitis / elevated liver enzymes
Rare (typically with antistaphylococcal penicillins) • moderate
Neutropenia / thrombocytopenia
Rare • moderate
Organized by affected organ systems
How to discuss side effects with families
Management protocols and monitoring
Common concerns and practical guidance
Dicloxacillin capsules need strict timing—empty stomach dosing every 6 hours is essential for reliable MSSA coverage.
Different formulations and concentrations
Safe preparation and measuring techniques
Tailored approaches for different ages
Solutions for common challenges
Storage guidelines and safety tips
Expert pearls and evidence-based tips
Dicloxacillin is a penicillinase-resistant beta-lactam that achieves high activity against methicillin-susceptible Staphylococcus aureus (MSSA).
Simple explanations and helpful analogies
Receptors, enzymes, and cellular targets
Absorption, metabolism, and elimination
Age-related differences and special populations
Stewardship and adherence pearls for dicloxacillin in pediatric MSSA care.
Core insights every provider should know
Recent updates that change how we practice
Organized by dosing, administration, and safety
How to explain treatments to families
Real-world cases with evidence-based approaches
Key numbers, algorithms, and decision tools
Understanding your child's medication is important. We've created comprehensive guides to help you safely administer Dicloxacillin and monitor your child's response to treatment.
Food significantly lowers absorption. Taking doses 1 hour before or 2 hours after meals keeps blood levels high enough to kill MSSA bacteria.
Take it as soon as you remember if it’s within about 2 hours. Otherwise skip it and go back to the regular schedule—never double up doses.
Most skin infections improve within 48–72 hours. Call your clinician if redness spreads, fever persists, or drainage increases despite treatment.