Effect of Cloxacillin on Bilirubin-albumin Binding

Main Article Content

Achmad Surjono


Cloxacillin is usually given to newborn infants with sepsis in particular for penicillinase-producing staphylococcus aureus. The effect of cloxacillin on bilirubin-albumin binding was investigated in vitro using the peroxidase oxidation method with human albumin (bilirubin 0.255 mM, albumin 0.45 mM, billalb 0.56, pH 7.4, temperature 3 0°C). Sulfisoxazole, a drug which is capable of displacing bilirubin from albumin was used as control.

The displacement constant of cloxacillin was 4.86 x 1o5 Nr1, stronger than that of sulfisoxazole (1. 72 x 104 M-1). Both drugs were capable of displacing bilirubin as determined by their maximal displacement factors of 2.21 and 2.29, respectively. Since cloxacillin apparently increases the risk of bilirubin encephalopathy the use of this drug in jaundiced newborns with sepsis, especially in the premature infants, should be reconsidered.

Article Details

How to Cite
Surjono A. Effect of Cloxacillin on Bilirubin-albumin Binding. PI [Internet]. 11Dec.2018 [cited 5Jul.2020];33(1-2):20-. Available from: https://paediatricaindonesiana.org/index.php/paediatrica-indonesiana/article/view/2052
Received 2018-12-11
Published 2018-12-11


1. Wennberg RP, Ahlfors CE. Free bilirubin is of importance Pediatrics 1982; 70 : 685 - 9.
2. Brodersen R, Frish-Hansen B, Stern L. Drug-induced displacement of bilirubin from albumin in the newborn. Dev Pharmacol Ther 1983; 6 : 217- 29.
3. Surjono A. Displacement of bilirubin from human albumin by drugs. B I Kedokt 1986; 18 : 91 - 7.
4. Shimabuku R Nakamura H. Total and unbound bilirrubin determination using an automated peroxidase micromethod. Kobe J Med Sci 1982; 28 : 91 - 104.
5. Brodersen R, Robertson A. Chemistry of bilirubin and its interaction with albumin. In : Meisels MJ, ed. Hyperbilirubinemia in the newborn. Colombus: Ross Lab 1983; 91c100.
6. Fink S, Karp W, Robertson A. Effect of penicillins on bilirubin-albumin binding. J Pediat 1988; 566 - 8.