Flucloxacillin is highly effective against Streptococcus pyogenes (group A strep) and related species

A common myth – “Flucloxacillin and penicillin in combination are required to treat cellulitis”

NOT TRUE: monotherapy is adequate.

The two most common causative organisms in cellulitis (in order) are Streptococcus pyogenes) and Staphylococcus aureus. The mean Minimal Inhibitory Concentrations (MIC) of flucloxacillin for methicillin-susceptible S. aureus (MSSA) is 0.4 μg/ml and 0.04 for S. pyogenes (i.e. S. pyogenes is more sensitive than S. aureus to flucoxacillin).

Serum levels of dicloxacillin or flucoxacillin after usual doses are more than adequate for treatment.

And so, flucloxacillin alone is more than adequate to cover both S. aureus  and S. pyogenes infection.

Note that the widespread emergence of community strains of MRSA that cause skin and soft tissue infection – especially boils or cellulitis in association with venous ulcers may render di/flucloxacillin ineffective.

 

4 comments

  1. Hey! I know this iss sort of off-topic but I had to ask.
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    1. Hi Gabrielle

      Quite a bit of thought goes in to each of our postings. Several key things- use twitter to publicise your blog posting and hand amend the twitter mention in the wordpress software before publishing. Put a relevant photo for the posting as the key image and also include something in the post itself. Always use the read more tag. AND always think hard on the title of the posting ; avoid colons or dashes and try for a short catchy phrase. Best to do all of this before you post as subsequent edits wont go out as notifications. Good luck!
      John

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  2. […] Infections due to these species of streptococci are usually rapidly responsive to appropriate antibiotic therapy which can be of short duration with no minimum IV requirement as endocarditis is not a usual consideration.  Penicillin resistance has not been documented and flucloxacillin is just as active (see this discussion). […]

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  3. […] FLUCLOXACILLIN IS HIGHLY EFFECTIVE AGAINST STREPTOCOCCUS PYOGENES (GROUP A STREP) AND RELATED SPECI… (Jan 2015) – we returned to this topic to unpack a few more misconceptions this year in July with: […]

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