雙氯西林
Dicloxacillin
Dicloxacillin sodium
別名: Dynapen · Dicloxin · sodium dicloxacillin · dichlorphenylmethyl isoxazolyl penicillin sodium · methyldichlorophenyl isoxazolyl penicillin sodium · dicloxacilina sodica · dicloxacillinum natricum · P-1011
由 VetSheet 獸醫團隊審訂更新於 2026年4月5日本內容以實證獸醫文獻為本
劑量為持牌獸醫專業人員的臨床參考。請務必對照最新藥品說明書及個別病患確認。
各物種劑量
🌎 NA — North America🌍 EU — Europe
狗
| 適應症 | 劑量 | 途徑 | 頻次 | 療程 | 地區 |
|---|---|---|---|---|---|
| Localized soft tissue infections or skin infections caused by susceptible (non-beta-lactamase producers) bacteria | 25 mg/kg PO q6h | PO | q6h | 14-84 days | 🌎 NA |
| Dermatologic infections | 22 mg/kg PO q8h | PO | q8h | — | 🌎 NA |
| Recurrent skin infections | 20-30 mg/kg PO three times daily | PO | q8h | — | 🌎 NA |
- Recurrent skin infections: Food may decrease absorption
貓
| 適應症 | 劑量 | 途徑 | 頻次 | 療程 | 地區 |
|---|---|---|---|---|---|
| Localized soft tissue infections or skin infections caused by susceptible (non-beta-lactamase producers) bacteria | 25 mg/kg PO q6h | PO | q6h | 14-84 days | 🌎 NA |
劑量為持牌獸醫專業人員的臨床參考。請務必對照最新藥品說明書及個別病患確認。
概覽
雙氯西林（Dicloxacillin）是一種口服、窄效的抗青黴素酶（異惡唑基）青黴素。在獸醫學中，主要用於口服治療由產生β-內醯胺酶的葡萄球菌引起的軟組織、皮膚和骨骼感染。
臨床要點：由於其龐大的異惡唑基側鏈，它能抵抗葡萄球菌β-內醯胺酶的降解。然而，其在犬隻體內的口服生物利用度差（約23%）且半衰期短，需要頻繁給藥（每6-8小時一次），這可能影響飼主的依從性。由於這些藥代動力學的限制，小動物臨床上通常更傾向使用其他抗葡萄球菌藥物（如頭孢氨苄或阿莫西林-克拉維酸）。
作用機制
Dicloxacillin is a bactericidal beta-lactam antibiotic.
- It binds to specific Penicillin-Binding Proteins (PBPs) located inside the bacterial cell wall.
- This binding inhibits the third and final stage of bacterial cell wall synthesis → blocks the cross-linking of peptidoglycan.
- The weakened cell wall leads to the activation of autolysins → cell lysis and bacterial death.
- Its bulky side chain prevents the beta-lactam ring from being hydrolyzed by staphylococcal penicillinase.
安全性與警告
禁忌症
- Hypersensitivity to penicillins
- Septicemia, shock, or other grave illnesses (oral absorption may be significantly delayed or diminished)
不良反應
- Anorexia
- Vomiting
- Antibiotic-associated diarrhea (superinfections)
- Hypersensitivity reactions (rashes, fever, eosinophilia, anaphylaxis)
- Neurotoxicity (ataxia at very high doses)
- Elevated liver enzymes
- Tachypnea
- Dyspnea
- Edema
- Tachycardia
注意事項
Use cautiously in patients with documented hypersensitivity to other beta-lactam antibiotics (e.g., cephalosporins, cefamycins, carbapenems) due to potential cross-reactivity. Do not administer systemic antibiotics orally in patients with septicemia, shock, or other grave illnesses; parenteral routes should be used.
藥物相互作用
In vitro evidence of synergism with dicloxacillin against S. aureus strains; however, penicillins can inactivate aminoglycosides in vitro, so do not mix in the same syringe/fluid line.
Dicloxacillin may reduce cyclosporine levels.
Competitively blocks the tubular secretion of dicloxacillin, thereby increasing serum levels and serum half-lives.
Theoretical antagonism; concurrent use is usually not recommended.
Dicloxacillin may cause decreased warfarin efficacy.
監測
- Clinical efficacy (resolution of infection)
- Toxic clinical signs (GI upset, hypersensitivity)
藥物動力學
半衰期
吸收
Resistant to acid inactivation in the gut but only partially absorbed. Bioavailability in dogs is ~23%. Food decreases both the rate and extent of absorption.
分佈
Distributes to liver, kidneys, bone, bile, pleural, synovial, and ascitic fluids. Minimal amounts distribute into the CSF. Approximately 95-99% bound to plasma proteins in humans.
代謝
Partially metabolized to both active and inactive metabolites.
排除
Rapidly excreted in the urine via both glomerular filtration and tubular secretion mechanisms. A small amount is excreted in the feces via biliary elimination.
過量
Acute oral penicillin overdoses are unlikely to cause significant problems other than GI distress (vomiting, diarrhea). In humans, very high dosages of parenteral penicillins, especially in patients with renal disease, have induced CNS effects (neurotoxicity).
可用產品
劑型
- Capsules
- Oral suspension
獸醫用
- Dicloxin® 100 mg and 500 mg capsules (Historically approved for dogs; no products apparently currently marketed in the USA)
人用標示
- Dicloxacillin Sodium Capsules: 250 mg & 500 mg (generic)
各地核准狀態
暫無法規資料: 🇺🇸 US · 🇪🇺 EU · 🇬🇧 UK · 🇭🇰 HK · 🇹🇼 TW · 🇯🇵 JP · 🇰🇷 KR · 🇦🇺 AU
儲存與穩定性
Capsules should be stored at temperatures less than 40°C and preferably at room temperature (15-30°C). Reconstituted oral suspensions should be kept refrigerated and discarded after 14 days.
飼主須知
重要提示：請在空腹時（飯前1小時或飯後2小時）給予此藥物，以確保良好吸收。如果您的寵物服藥後嘔吐或感到不適，可以搭配少量零食或食物給予。
- 依從性是關鍵：請務必按照處方完成整個療程，即使寵物看起來已經康復。漏服藥物可能導致抗藥性感染。
- 如果使用的是泡製的口服懸浮液，請將其保存在冰箱中，並在14天後丟棄未用完的部分。
- 請留意過敏反應（如蕁麻疹、臉部腫脹、呼吸困難）或嚴重腹瀉的跡象，若出現這些情況請立即聯繫您的獸醫師。
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