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Should probenecid be used to reduce the dicloxacillin dosage in orthopaedic infections? A study of the dicloxacillin-saving effect of probenecid.

Abstract
Reduction in the dosage of dicloxacillin from 500 mg to 250 mg 3 times a day would mean lowering of costs and less side-effects in orthopaedic infections. In this cross-over study, the serum concentrations of dicloxacillin were measured in 9 patients after administration of dicloxacillin 500 mg 3 times a day (dicloxacillin 500 mg) and after co-administration of 250 mg dicloxacillin and 250 mg probenecid 3 times per day (dicloxacillin 250 mg+probenecid 250 mg). Concentrations were measured every hour after the tablet intake. The mean maximum serum concentrations of dicloxacillin were 17.1 micrograms/ml (dicloxacillin 500 mg) and 12.2 micrograms/ml (dicloxacillin 250 mg+probenecid 250 mg), respectively (P < 0.05). Serum concentrations above 3 micrograms/ml were obtained during 285 min. in both regimes, but the individual variations were biggest during in the dicloxacillin 250 mg+probenecid 250 mg treatment. Serum concentrations above 5 micrograms/ml were in mean measured during 228 min. (dicloxacillin 500 mg) and 190 min. (dicloxacillin 250 mg+probenecid 250 mg), respectively (P < 0.05). The clinical significance of these findings is being discussed. In theory, treatment with dicloxacillin 250 mg+probenecid 250 mg may be as sufficient as dicloxacillin 500 mg.
AuthorsM R Krogsgaard, B A Hansen, T Slotsbjerg, P Jensen
JournalPharmacology & toxicology (Pharmacol Toxicol) Vol. 74 Issue 3 Pg. 181-4 (Mar 1994) ISSN: 0901-9928 [Print] Denmark
PMID8008725 (Publication Type: Clinical Trial, Comparative Study, Journal Article, Randomized Controlled Trial)
Chemical References
  • Dicloxacillin
  • Probenecid
Topics
  • Administration, Oral
  • Biological Availability
  • Dicloxacillin (administration & dosage, blood, economics)
  • Drug Therapy, Combination
  • Humans
  • Orthopedics
  • Postoperative Complications (drug therapy)
  • Probenecid (administration & dosage, blood, economics)
  • Staphylococcal Infections (drug therapy)

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