Hey I shot left Tricep on monday and its still swollen a bit, doesn't hurt and no fever but its a tiny bit red and still swollen some, It was my first injection there and I know my first injection in my leg swelled a bit. Think I should be worried about it??? If i touch it is a bit warm but that might be because I wont leave it alone, how long should I let it go before looking at going to a doc??? Also I do have 4 Amoxicillin/Augmentin pills in my medicine cabnit and 40+ Dicloxacillan 500mg tabs, both are antibiotics. Should I take them??? Im starting to freak myself out here.
Dicloxacillan
Dicloxacillin (INN) is a narrow spectrum beta-lactam antibiotic. It is used to treat infections caused by susceptible Gram-positive bacteria. Notably, it is active against beta-lactamase-producing organisms such as Staphylococcus aureus, which would otherwise be resistant to most penicillins. It is very similar to flucloxacillin and these two agents are considered interchangeable. Dicloxacillin is available under a variety of trade names including Diclocil (BMS).Like other β-lactam antibiotics, dicloxacillin acts by inhibiting the synthesis of bacterial cell walls. It inhibits cross-linkage between the linear peptidoglycan polymer chains that make up a major component of the cell wall of Gram-positive bacteria.
Medicinal chemistry
Dicloxacillin is insensitive to beta-lactamase (also known as penicillinase) enzymes secreted by many penicillin-resistant bacteria. The presence of the isoxazolyl group on the side chain of the penicillin nucleus facilitates the β-lactamase resistance, since they are relatively intolerant of side-chain steric hindrance. Thus it is able to bind to penicillin binding proteins (PBPs) and inhibit peptidoglycan crosslinking, but is not bound by or inactivated by β-lactamases.
Clinical use
Dicloxacillin is more acid-stable than many other penicillins and can be given orally, in addition to parenteral routes. However, like methicillin, it is less potent than benzylpenicillin against non-β-lactamase-producing Gram-positive bacteria.
Dicloxacillin has similar pharmacokinetics, antibacterial activity and indications to flucloxacillin and the two agents are considered interchangeable. It is believed to have lower incidence of severe hepatic adverse effects than flucloxacillin, but a higher incidence of renal adverse effects. (Rossi, 2006)
Indications
Dicloxacillin is indicated for the treatment of infections caused by susceptible bacteria. Specific approved indications include: (Rossi, 2006)
Staphylococcal skin infections and cellulitis – including impetigo, otitis externa, folliculitis, boils, carbuncles, and mastitis
Pneumonia (adjunct) Osteomyelitis, septic arthritis
Septicaemia
Empirical treatment for endocarditis
Surgical prophylaxis
Precautions/contraindications
Dicloxacillin is contraindicated in those with a previous history of allergy to penicillins, cephalosporins or carbapenems. It should also not be used in the eye, or those with a history of cholestatic hepatitis associated with the use of dicloxacillin or dicloxacillin. (Rossi, 2006)
It should be used with caution in the elderly, patients with renal impairment, where a reduced dose is required; and those with hepatic impairment, due to the risk of cholestatic hepatitis. (Rossi, 2006)
Adverse effects
Common adverse drug reactions (ADRs) associated with the use of dicloxacillin include: diarrhoea, nausea, rash, urticaria, pain and inflammation at injection site, superinfection (including candidiasis), allergy, and transient increases in liver enzymes and bilirubin. (Rossi, 2006)
Rarely, cholestatic jaundice (also referred to as cholestatic hepatitis) has been associated with dicloxacillin therapy. The reaction may occur up to several weeks after treatment has stopped, and takes weeks to resolve. The estimated incidence is 1 in 15,000 exposures, and is more frequent in people >55 years, females, and those with treatment longer than 2 weeks. (Joint Formulary Committee, 2005; Rossi, 2006)
Resistance
Despite dicloxacillin being insensitive to beta-lactamses, some organisms have developed resistance to it and other narrow-spectrum β-lactam antibiotics including methicillin. Such organisms include methicillin-resistant Staphylococcus aureus (MRSA).
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Originally Posted by cj1capp
