{
  "schema_version": 1,
  "kind": "condition",
  "id": "pressure-ulcer",
  "name": "Pressure ulcer",
  "category": "acute",
  "sources": "Egyptian National Drug Formulary - antimicrobial-2023.pdf, Flucloxacillin monograph (chapter PDF p361) · Zaidi SRH, El Khatib S, Sharma S. Pressure Injury. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2026 Jan-. NBK553107.",
  "review_status": "reviewed",
  "verified_against": "Egyptian National Drug Formulary - antimicrobial-2023.pdf, Flucloxacillin monograph (chapter PDF p361)",
  "verified_date": "2026-08",
  "treatments": [
    {
      "id": 1534,
      "generic": "Flucloxacillin",
      "line": 2,
      "is_adjunct": false,
      "form": "oral.solid",
      "strength_mg": null,
      "adult_dose": "250 mg orally (or by intramuscular injection) four times daily; the dose may be doubled for a severe infection.",
      "adult_duration": null,
      "dose_source": "Egyptian National Drug Formulary - antimicrobial-2023.pdf, Flucloxacillin monograph (chapter PDF p361)",
      "rationale": "An infected pressure ulcer is a skin and soft tissue infection typically involving staphylococci/streptococci at the wound margin; flucloxacillin at the standard skin-infection dose (with the option to double it for a more severe infection) is appropriate first-line oral empirical cover for localised infection.",
      "cautions": [
        "Signs of deep tissue infection, osteomyelitis, or sepsis from an infected pressure ulcer need urgent referral.",
        "Flucloxacillin is only for a clinically infected ulcer - spreading redness/warmth, increasing pain, purulent discharge, fever - not for a colonised but clean wound, which does not need antibiotics.",
        "Covers staphylococci/streptococci around the wound edge; if the ulcer is deep, malodorous, or not responding, suspect mixed anaerobic/Gram-negative infection or osteomyelitis and refer rather than continuing oral flucloxacillin alone.",
        "Avoid in penicillin allergy.",
        "Combine with pressure offloading, regular repositioning, and wound dressing - antibiotics alone do not heal a pressure ulcer.",
        "Oral: Take flucloxacillin on an empty stomach. This means 30 to 60 minutes before a meal or snack, or at least 2 hours after.",
        "Hepatitis and cholestatic jaundice have been reported occasionally with flucloxacillin and may be delayed in onset for up to 2 months after treatment has been stopped; older patients and those receiving flucloxacillin for more than 2 weeks are at greater risk."
      ],
      "peds_mgkg_low": null,
      "peds_mgkg_high": null,
      "peds_max_mg": null,
      "peds_basis": null,
      "peds_unit": null,
      "peds_note": "Paediatric dosing is specialist-set and is not reproduced here.",
      "peds_min_weight_kg": null,
      "peds_max_weight_kg": null,
      "peds_age_min_months": null,
      "peds_age_max_months": null,
      "peds_age_bands": null,
      "peds_doses": null,
      "brands": [
        {
          "trade_name": "FLUMOCIN 250MG 12CAPS.",
          "scientific_name": null,
          "normalized_ingredient": null,
          "manufacturer": "UP PHARMA",
          "price_egp": 6.2,
          "pack_count": 12,
          "unit_price": 0.52,
          "strength_mg": 250.0,
          "exact_strength": true,
          "exact_form": true,
          "discontinued": false,
          "also_contains": "amoxicillin"
        },
        {
          "trade_name": "AMOFLUX 125/125MG 12 CAPS.",
          "scientific_name": null,
          "normalized_ingredient": null,
          "manufacturer": "RAMEDA > DELTA PHARMA",
          "price_egp": 8.25,
          "pack_count": 12,
          "unit_price": 0.69,
          "strength_mg": 125.0,
          "exact_strength": true,
          "exact_form": true,
          "discontinued": false,
          "also_contains": "amoxicillin"
        },
        {
          "trade_name": "FLUCAMOX 250MG 12CAPS.",
          "scientific_name": null,
          "normalized_ingredient": null,
          "manufacturer": "SEDICO",
          "price_egp": 8.25,
          "pack_count": 12,
          "unit_price": 0.69,
          "strength_mg": 250.0,
          "exact_strength": true,
          "exact_form": true,
          "discontinued": false,
          "also_contains": "amoxicillin"
        },
        {
          "trade_name": "FLUMOCIN 500MG 8 CAPS.",
          "scientific_name": null,
          "normalized_ingredient": null,
          "manufacturer": "UP PHARMA",
          "price_egp": 6.0,
          "pack_count": 8,
          "unit_price": 0.75,
          "strength_mg": 500.0,
          "exact_strength": true,
          "exact_form": true,
          "discontinued": false,
          "also_contains": "amoxicillin"
        },
        {
          "trade_name": "CURAFLUX 125/125 MG 12 CAPS.",
          "scientific_name": null,
          "normalized_ingredient": null,
          "manufacturer": "RAMEDA > PIONEER",
          "price_egp": 12.5,
          "pack_count": 12,
          "unit_price": 1.04,
          "strength_mg": 125.0,
          "exact_strength": true,
          "exact_form": true,
          "discontinued": false,
          "also_contains": "amoxicillin"
        },
        {
          "trade_name": "AMOFLUX 250/250MG 16 CAPS.",
          "scientific_name": null,
          "normalized_ingredient": null,
          "manufacturer": "RAMEDA > PIONEER",
          "price_egp": 18.0,
          "pack_count": 16,
          "unit_price": 1.12,
          "strength_mg": 250.0,
          "exact_strength": true,
          "exact_form": true,
          "discontinued": false,
          "also_contains": "amoxicillin"
        },
        {
          "trade_name": "HI-FLUCIL 250/250MG 16 CAPS.",
          "scientific_name": null,
          "normalized_ingredient": null,
          "manufacturer": "CID",
          "price_egp": 20.0,
          "pack_count": 16,
          "unit_price": 1.25,
          "strength_mg": 250.0,
          "exact_strength": true,
          "exact_form": true,
          "discontinued": false,
          "also_contains": "amoxicillin"
        },
        {
          "trade_name": "AMPIFLUX 500 MG 12 CAPS.",
          "scientific_name": null,
          "normalized_ingredient": null,
          "manufacturer": "PHARCO",
          "price_egp": 16.0,
          "pack_count": 12,
          "unit_price": 1.33,
          "strength_mg": 500.0,
          "exact_strength": true,
          "exact_form": true,
          "discontinued": false,
          "also_contains": "ampicillin"
        }
      ],
      "condition_id": "pressure-ulcer"
    }
  ]
}