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kullervo's avatar

What is the earliest I can safely stop my daughter taking Flucloxacillin antibiotic?

Asked by kullervo (780 points ) March 23rd, 2014

My daughter has ben incorrectly prescribed too high a dosage of an antibiotic and I cannot reach the Dr tonight. She is taking 250mg (5ml) every 6hrs and for her weight it should be closer to 200mg. She is having stomach upset. Is it safe to stop anytime, or reduce the dosage or is it best to finish the course?

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17 Answers

Seek's avatar

Don’t know where your information is coming from regarding the recommended dosage, but everything I’m finding shows recommended dosage at 250 for children between 2 and 10.

I’m certain that dosing as prescribed until you can reach the doctor in the morning isn’t going to do her harm. However, under-dosing her can reduce the efficacy of the drug and prolong the illness.

I’m not a doctor

CWOTUS's avatar

I would recommend that you consult a pharmacist if you suspect any kind of overdose situation. Professional pharmacists often know more about the drugs they dispense than the doctors who prescribe them.

If the pharmacist tells you that the antibiotic won’t hurt your daughter, then I’d follow the prescription until I could consult the doctor in the morning.

Seek's avatar

FYI:

http://www.medsafe.govt.nz/profs/datasheet/f/FlucloxacillinAFTcapssoln.pdf

Hypersensitivity reactions: if any hypersensitivity reaction occurs, the treatment should be discontinued

Rash, urticaria, purpura, fever, eosinophilia; sometimes angioneurotic oedema, rarely
anaphylactic shock (exceptional with oral administration) (see Warnings and Precautions).
Certain reactions (fever, arthralgia, myalgia) sometimes develop more than 48 hours after
the start of the treatment. Erythema multiforme has been reported rarely.
Gastrointestinal reactions: minor gastrointestinal disturbances may occur during treatment.
As with other antibiotics, pseudomembranous colitis has been reported rarely. If this
condition develops, flucloxacillin treatment should be discontinued and appropriate therapy,
e.g. oral vancomycin should be initiated.
Hepatic effects: hepatitis and cholestatic jaundice have been reported (see Warnings and
Precautions). These may be delayed for up to two months post-treatment. In some cases the
course has been protracted and lasted for several months. Very rarely, deaths have been
reported, almost always in patients with serious underlying disease.
Changes in liver function test results may occur, but are reversible when treatment is
discontinued.
Renal effects: interstitial nephritis may occur but is reversible when treatment is discontinued.
Haematological effects:
Neutropenia (including agranulocytosis) and thrombocytopenia may occur but are reversible
when treatment is discontinued.
Neurological Effects: In patients suffering from renal failure, neurological disorders with
convulsions are possible with high doses (mainly parenteral)

Seaofclouds's avatar

How long has she been taking the medication?
Who stated that she was given the wrong dosage?
Have you already spoken with the pharmacist (since you can’t reach the doctor)?
Is she taking the medication with or without food?
Is the upset stomach accompanied with diarrhea or vomiting?
Does she have any allergies to other medications?
Does your doctor’s office have someone on call you can reach during non-office hours? If so, try reaching them tonight.

Normally, it is not a good idea to stop taking antibiotics before completing the intended course because it can lead to the bacteria becoming resistant to the antibiotic and tougher to treat. Having an upset stomach is a common side effect of many antibiotics. I’d recommend trying to get in touch with the pharmacist if you can not reach the doctor tonight. As long as she is just having an upset stomach, I wouldn’t stop the medication until speaking with either the pharmacist or doctor, preferably the doctor in case they want to change to a different medication so there is no lapse in treatment.

janbb's avatar

(@Seaofclouds is a nurse.)

kullervo's avatar

Another issue is that the label from the pharmacy covered the information that it should be kept refrigerated and so it has also been incorrectly stored (5 days now) there are 1.5 days left on the course.

Is it worse to keep giving with incorrectly stored antibiotic?

JLeslie's avatar

We are missing all sorts of info. What is your daughter’s age, weight, how many days has she been taking it, how many times a day, what is she sick with?

I don’t understand not being able to get in touch with a doctor, can’t you have him paged?

I looked up the drug, I am not very familiar with it, and it says to take at least a half before a meal, but it also says reduced absorption when taken with food, so sometimes that means taking it with food is ok. Food often prevent nausea with a lot of antibiotics, but you would need to know if it is ok to do. Some drugs you can do it, and some it is an absolute no no. Have you tried giving her food as soon as she is allowed to eat? Check what I have said here with a pharmacist, don’t trust what I looked up, but do try eating as soon as possible.

She very well might be overmedicated, but stopping the drug early can mean she will not get rid of the bacteria and she will have to start all over again on a new antibiotic for a full course if that happens. I saw some dosage recommendations that said that drugs should be started on a loading dose initially of 250 for children and then reduced to 125. is she taking the capsule? If so you cannot “split” a capsule in any way shape or form. If she is taking the liquid you can reduce it if a pharmacist can give you information on typical dosage, taking her weight into consideration. It would be better if a doctor switched her medication probably. If you have the capsule and the information you get from the pharmacist is she is being overdosed, then I would space out the dose a little. If she is taking it three times a day, I would give it to her every 10 hours, but then you have to really watch the clock and set alarms.

I am NOT a doctor, this is just what I would do for myself. Under medicating an infection again can mean having to start all over again on a new full corse of antibiotics. But, if it is like taking poison when she takes it, she should not be suffering so much from an antibiotic. Women and children are often overmedicated. The best solution is contacting a medical professional who can advise you accurately on whether it is reasonable to reduce the meds, and if not, then switch her to another med without interruption so she does not have to start all over.

JLeslie's avatar

Just 1.5 days left? And, it is the liquid? And, it wasn’t refrigerated. Oy. Have you been giving it on an empty stomach? Go ahead and give her ⅔ dose I think. That is my nonmedical opinion. And, put it in the fridge. Then hope for the best. Remember, you should never take internet advice as the gospel.

kullervo's avatar

Age: 7 , Weight: 18kg, Liquid form taken on empty stomach (as prescribed).

We will get medical advice in the morning we just wanted to get some pointers as she is due 2 more doses before the morning.

creative1's avatar

Upset stomach and diareah is a know side effect of most antibiotics, one of my daughters get it everytime she has been on antibiotics. If you are questioning things you can always call a pharmacy that is open, any pharmacist would be willing to let you know side effects and if the dosage seems correct for your child.

Adagio's avatar

If it were me I would contact the pharmacist as others have suggested, any pharmacist, they know their stuff, it is their profession.

kritiper's avatar

You must finish the course of antibiotic, or until the Dr. says otherwise. To stop, you risk increased danger from a more formidable infection, such as MRSA or the like.

JLeslie's avatar

18 kg. That is definitely a child’s weight. It does seem like she is overmedicated, BUT, I don’t know her infection, there might be a specific reason the doctor prescribed a high dose. Did you tell us what she is I’ll with? I might have missed it.

Why can’t you page the doctor?

@kritiper Where the heck did you get MRSA? She doesn’t have a MRSA infection as far as I know. Why scare the OP like that. Hopefully, he knows better.

JLeslie's avatar

Typo: ill not I’ll.

gailcalled's avatar

My recent experience was with amoxicillin for a tooth infection. After 6 days of a 10 day course, I broke out in a full body rash and hives. Surgeon said to stop immediately and that the six days was enough under the circumstances. He sent me to my PCP asap to verify and document the rash and for OTC things to ease the itching while it calmed down. Deciding when it is underdosing is the doctor’s call.

Several months ago I developed an abcess over an surgical incision. After 48 hours on an sulfur-based antibiotic, I developed stomach related allergic reactions to it and again was told to stop immediately.The surgeon then switched the antibiotic (over the phone) for an 8-day course with the new medication.

I agree with a call to your pharmacist if you can’t raise the doctor; your pediactrician doesn’t have an emergency answering service or a doctor on call? You might ask him what the procedures are next time for such a situation.

I am an old person, at the opposite end of high-risk as a young child.

The issue of non-refrigeration is important to mention also. Didn’t the instruction label on the RX bottle say to refrigerate the pills? My pharmacist always mentions these detail to me.

JLeslie's avatar

You can also call the pharma company customer service. I’m not sure what country you are in. Google the manufacturer and get the telephone number. They usually only answer M-F but if you are having trouble getting and answer they can help. I just realized as I am writing this there must be a 24 hour pharmacy where you live! Call them. It does not have to be the pharmacy that filled the order.

@gailcalled She is taking liquid. It is supposed to be refrigerated. The insert says 8C which is about 45F I think.

Since the meds are making her sick, hopefully that is an indication the warmer temperatures didn’t affect the efficacy much.

kullervo's avatar

Phoned Dr (GP) in the morning and was told to stop the medication due to the incorrect storage and that we had done most of the course already.

Thanks everyone for your help/advice.

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