RT Journal Article
SR Electronic
T1 Lesson of the month 1: A rare adverse reaction between flucloxacillin and paracetamol
JF Clinical Medicine
JO Clin Med
FD Royal College of Physicians
SP 127
OP 128
DO 10.7861/clinmedicine.19-2-127
VO 19
IS 2
A1 William Osborne
A1 Aneeka Chavda
A1 George Katritsis
A1 Jon S Friedland
YR 2019
UL http://www.rcpjournals.org/content/19/2/127.abstract
AB 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.