Dicloxacillin

Oral health effects

• Oral candidiasis (thrush)

  Broad-spectrum antibiotics suppress commensal bacteria, allowing Candida overgrowth in the mouth.

  Mechanism: Loss of competitive inhibition from normal flora.

  Clinical management: Watch for thrush, especially with repeated courses; treat with an antifungal; reinforce hygiene.

• Antibiotic-associated diarrhea / gut dysbiosis

  Disruption of gut flora can cause diarrhea and C. difficile overgrowth.

  Clinical management: A probiotic (e.g., Saccharomyces boulardii) during the course may modestly lower the risk of antibiotic-associated diarrhea; the evidence is low certainty. Avoid probiotics in immunocompromised or severely ill patients. See the Gut Health page.

• Black hairy tongue and stomatitis

  Black or 'hairy' tongue and stomatitis (sore, inflamed oral mucosa) can occur, especially with oral penicillin therapy. Frequency not stated on the label.

  Clinical management: Teach daily tongue brushing/scraping and good oral hygiene. Bland rinses for soreness. Rule out candidiasis. Reassure the patient that it usually resolves after the course.