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Intravenous flucloxacillin treatment is associated with a high incidence of hypokalaemia.

Authors
  • van der Heijden, Charlotte D C C1
  • Duizer, Marleen L1
  • Fleuren, Hanneke W H A2
  • Veldman, Bart A1
  • Sprong, Tom1
  • Dofferhoff, Anton T S M1
  • Kramers, Cornelis1, 2, 3
  • 1 Dept. of Internal Medicine, Canisius Wilhelmina Hospital, Nijmegen, the Netherlands. , (Netherlands)
  • 2 Dept. of Pharmacy, Canisius Wilhelmina Hospital, Nijmegen, the Netherlands. , (Netherlands)
  • 3 Dept. of Pharmacology-Toxicology, Radboud University Medical Center, Nijmegen, the Netherlands. , (Netherlands)
Type
Published Article
Journal
British Journal of Clinical Pharmacology
Publisher
Wiley (Blackwell Publishing)
Publication Date
Dec 01, 2019
Volume
85
Issue
12
Pages
2886–2890
Identifiers
DOI: 10.1111/bcp.13969
PMID: 31026083
Source
Medline
Keywords
Language
English
License
Unknown

Abstract

Intravenous flucloxacillin is one of the most frequently used high-dose penicillin therapies in hospitalized patients, forming the cornerstone treatment of invasive Staphylococcus aureus infection. Being a nonreabsorbable anion, flucloxacillin has been suggested to cause hypokalaemia, although the frequency and magnitude of this unwanted effect is unknown. In a retrospective cohort, we investigated the incidence and extent of hypokalaemia after initiation of intravenous flucloxacillin or ceftriaxone therapy. In total, 77 patients receiving flucloxacillin (62% male, mean age 70.5 years) and 84 patients receiving ceftriaxone (46% male, mean age 70.8 years) were included. Hypokalaemia occurred significantly more often in patients receiving flucloxacillin than ceftriaxone (42% vs 14%, p < 10-4 ). Moreover, follow-up potassium levels were significantly lower during flucloxacillin therapy. In general, women were more prone to develop hypokalaemia than men. In conclusion, intravenous flucloxacillin use is associated with a striking incidence of hypokalaemia. Therefore, standardized potassium measurements are necessary. © 2019 The Authors. British Journal of Clinical Pharmacology published by John Wiley & Sons Ltd on behalf of British Pharmacological Society.

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