TY - JOUR T1 - Lesson of the month 1: A rare adverse reaction between flucloxacillin and paracetamol JF - Clinical Medicine JO - Clin Med SP - 127 LP - 128 DO - 10.7861/clinmedicine.19-2-127 VL - 19 IS - 2 AU - William Osborne AU - Aneeka Chavda AU - George Katritsis AU - Jon S Friedland Y1 - 2019/03/01 UR - http://www.rcpjournals.org/content/19/2/127.abstract N2 - Flucloxacillin, a beta-lactam antibiotic, is a commonly prescribed antibiotic for the treatment of infections caused by staphylococci and streptococci, most notably Staphylococcus aureus. Paracetamol is one of the most dispensed medications by NHS England and is used for the treatment of fever and pain.1 However most doctors are unaware that concurrent use of these drugs can cause a potentially fatal drug interaction due to pyroglutamic acidosis (PGA), also known as 5-oxoprolinaemia. PGA is a rare cause of raised anion gap metabolic acidosis due to disruption of the γ-glutamyl cycle. We report the case of a patient with multiple comorbidities who developed PGA due to coadministration of paracetamol and flucloxacillin. ER -