Lesson of the month 1: A rare adverse reaction between

Clin Med (Lond) · Mar 2019

Case Reports

Lesson of the month 1: A rare adverse reaction between flucloxacillin and paracetamol.

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.

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- William Osborne, Aneeka Chavda, George Katritsis, and Jon S Friedland.
- Department of Infectious Diseases, Royal Stoke University Hospital, Stoke-on-Trent, UK william.osborne@nhs.net.
- Clin Med (Lond). 2019 Mar 1; 19 (2): 127128127-128.
AbstractFlucloxacillin, 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.© Royal College of Physicians 2019. All rights reserved.

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Lesson of the month 1: A rare adverse reaction between flucloxacillin and paracetamol.

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