In healthy volunteers, taking flucloxacillin with food does not compromise effective plasma concentrations in most circumstances

PloS One
Sharon J GardinerEvan J Begg

Abstract

It is usually recommended that flucloxacillin is given on an empty stomach. The aim of this study was to compare total and free flucloxacillin concentrations after oral flucloxacillin, given with and without food, based on contemporary pharmacokinetic and pharmacodynamic targets. Flucloxacillin 1000 mg orally was given to 12 volunteers, after a standardised breakfast and while fasting, on two separate occasions. Flucloxacillin concentrations over 12 hours were measured by liquid chromatography-tandem mass spectrometry. Pharmacokinetic parameters, and pharmacodynamic endpoints related to target concentration achievement, were compared in the fed and fasting states. For free flucloxacillin, the fed/fasting area under the concentration-time curve from zero to infinity (AUC0-∞) ratio was 0.80 (p<0.01, 90% CI 0.70-0.92), the peak concentraton (Cmax) ratio 0.51 (p<0.001, 0.42-0.62) and the time to peak concentration (Tmax) ratio 2.2 (p<0.001, 1.87-2.55). The ratios for total flucloxacillin concentrations were similar. The mean (90% CI) fed/fasting ratios of free concentrations exceeded for 30%, 50% and 70% of the first 6 hours post-dose were 0.74 (0.63-0.87, fed inferior p<0.01), 0.95 (0.81-1.11, bioequivalent) and 1.15 (0.97-1.36, f...Continue Reading

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Citations

Jan 11, 2019·Toxicological Sciences : an Official Journal of the Society of Toxicology·Audrey BurbanAndré Guillouzo
Mar 3, 2020·Journal of Bone and Joint Infection·Helga Preissİlker Uçkay
Apr 3, 2021·APMIS : Acta Pathologica, Microbiologica, Et Immunologica Scandinavica·Khaled Ghathian, Niels Frimodt-Møller
May 9, 2021·British Journal of Clinical Pharmacology·Philip G DrennanStephen T Chambers
Jul 11, 2021·Clinical Microbiology and Infection : the Official Publication of the European Society of Clinical Microbiology and Infectious Diseases·Eveline WallenburgRob Ter Heine

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