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Syphilis
Adult: Usual dose: 0.5-1 g once daily, increased to 2 g once daily for neurosyphilis for 10-14 days. Doses are given via slow IV inj over 5 minutes, IV infusion over at least 30 minutes, or deep IM inj. For IM doses, not more than 1 g must be administered at one site. Consideration must be given to local treatment guidelines.
Child: <15 days 50 mg/kg daily via IV infusion over 60 minutes or deep IM inj for 10-14 days; 15 days to 12 years weighing <50 kg: 75-100 mg/kg once daily via IV infusion over at least 30 minutes or deep IM inj for 10-14 days. Max: 4 g once daily; >12 years weighing ≥50 kg: Same as adult dose. Doses >2 g must be given via IV. For IM doses, not more than 1 g must be administered at one site. Consideration must be given to local treatment guidelines.
Child: <15 days 50 mg/kg daily via IV infusion over 60 minutes or deep IM inj for 10-14 days; 15 days to 12 years weighing <50 kg: 75-100 mg/kg once daily via IV infusion over at least 30 minutes or deep IM inj for 10-14 days. Max: 4 g once daily; >12 years weighing ≥50 kg: Same as adult dose. Doses >2 g must be given via IV. For IM doses, not more than 1 g must be administered at one site. Consideration must be given to local treatment guidelines.
Intramuscular, Intravenous
Lyme disease
Adult: For early (stage II) and late (stage III) stage cases: 2 g once daily for 14-21 days. Doses are given via slow IV inj over 5 minutes, IV infusion over at least 30 minutes, or deep IM inj. For IM doses, not more than 1 g must be administered at one site. Treatment duration may vary based on the course of the disease. Consideration must be given to local treatment guidelines.
Child: 15 days to 12 years weighing <50 kg: 50-80 mg/kg once daily via IV infusion over at least 30 minutes or deep IM inj for 14-21 days; >12 years weighing ≥50kg: Same as adult dose. Doses >2 g must be given via IV. For IM doses, not more than 1 g must be administered at one site. Treatment duration may vary based on the course of the disease. Consideration must be given to local treatment guidelines.
Child: 15 days to 12 years weighing <50 kg: 50-80 mg/kg once daily via IV infusion over at least 30 minutes or deep IM inj for 14-21 days; >12 years weighing ≥50kg: Same as adult dose. Doses >2 g must be given via IV. For IM doses, not more than 1 g must be administered at one site. Treatment duration may vary based on the course of the disease. Consideration must be given to local treatment guidelines.
Intramuscular, Intravenous
Bacterial meningitis
Adult: Usual dose: 2-4 g once daily or in 2 divided doses via slow IV inj over 5 minutes, IV infusion over at least 30 minutes, or deep IM inj. Doses >2 g must be given via IV inj or infusion. For IM doses, not more than 1 g must be administered at one site. Treatment duration may vary based on the course of the disease. Consideration must be given to local treatment guidelines.
Child: <15 days 50 mg/kg once daily or in 2 divided doses via IV infusion over 60 minutes or deep IM inj; 15 days to 12 years weighing <50 kg: 80-100 mg/kg once daily or in 2 divided doses via IV infusion over at least 30 minutes or deep IM inj, up to Max of 4 g daily; >12 years weighing ≥50 kg: Same as adult dose. Doses >2 g must be given via IV. For IM doses, not more than 1 g must be administered at one site. Treatment duration may vary based on the course of the disease. Consideration must be given to local treatment guidelines.
Child: <15 days 50 mg/kg once daily or in 2 divided doses via IV infusion over 60 minutes or deep IM inj; 15 days to 12 years weighing <50 kg: 80-100 mg/kg once daily or in 2 divided doses via IV infusion over at least 30 minutes or deep IM inj, up to Max of 4 g daily; >12 years weighing ≥50 kg: Same as adult dose. Doses >2 g must be given via IV. For IM doses, not more than 1 g must be administered at one site. Treatment duration may vary based on the course of the disease. Consideration must be given to local treatment guidelines.
Intramuscular, Intravenous
Bone and joint infections, Community-acquired pneumonia, Intra-abdominal infections, Lower respiratory tract infections, Septicaemia, Skin and soft tissue infections, Urinary tract infections
Adult: Usual dose: 1-2 g daily, increased to 4 g daily in severe infections, to be given once daily or in 2 divided doses via slow IV inj over 5 minutes, IV infusion over at least 30 minutes, or deep IM inj. Doses >2 g must be given via IV inj or infusion. For IM doses, not more than 1 g must be administered at one site. Treatment duration may vary based on the course of the disease. Consideration must be given to local treatment guidelines.
Child: <15 days 20-50 mg/kg once daily via IV infusion over 60 minutes or deep IM inj. Max: 50 mg/kg daily; 15 days to 12 years weighing <50 kg: 50-80 mg/kg once daily or in 2 divided doses via IV infusion over at least 30 minutes or deep IM inj, may be increased to 100 mg/kg daily in severe infections up to Max of 4 g daily; >12 years weighing ≥50 kg: Same as adult dose. Doses >2 g must be given via IV. For IM doses, not more than 1 g must be administered at one site. Treatment duration may vary based on the course of the disease. Consideration must be given to local treatment guidelines.
Child: <15 days 20-50 mg/kg once daily via IV infusion over 60 minutes or deep IM inj. Max: 50 mg/kg daily; 15 days to 12 years weighing <50 kg: 50-80 mg/kg once daily or in 2 divided doses via IV infusion over at least 30 minutes or deep IM inj, may be increased to 100 mg/kg daily in severe infections up to Max of 4 g daily; >12 years weighing ≥50 kg: Same as adult dose. Doses >2 g must be given via IV. For IM doses, not more than 1 g must be administered at one site. Treatment duration may vary based on the course of the disease. Consideration must be given to local treatment guidelines.
Intramuscular, Intravenous
Prophylaxis of surgical infections
Adult: 1-2 g as a single dose given 30 minutes to 2 hours before surgery via slow IV inj over 5 minutes, IV infusion over at least 30 minutes, or deep IM inj. For IM doses, not more than 1 g must be administered at one site. Consideration must be given to local treatment guidelines.
Child: <15 days 20-50 mg/kg as single pre-operative dose via IV infusion over 60 minutes or deep IM inj; 15 days to 12 years weighing <50 kg: 50-80 mg/kg as a single pre-operative dose via IV infusion over at least 30 minutes or deep IM inj; >12 years weighing ≥50kg: Same as adult dose. Doses to be given 30-90 minutes before surgery. Doses >2 g must be given via IV. For IM doses, not more than 1 g must be administered at one site. Consideration must be given to local treatment guidelines.
Child: <15 days 20-50 mg/kg as single pre-operative dose via IV infusion over 60 minutes or deep IM inj; 15 days to 12 years weighing <50 kg: 50-80 mg/kg as a single pre-operative dose via IV infusion over at least 30 minutes or deep IM inj; >12 years weighing ≥50kg: Same as adult dose. Doses to be given 30-90 minutes before surgery. Doses >2 g must be given via IV. For IM doses, not more than 1 g must be administered at one site. Consideration must be given to local treatment guidelines.
Intramuscular
Acute otitis media
Adult: 1-2 g as a single dose. Consideration must be given to local treatment guidelines.
Child: ≤12 years weighing <50 kg: 50 mg/kg as a single dose; >12 years weighing ≥50kg: Same as adult dose.
Child: ≤12 years weighing <50 kg: 50 mg/kg as a single dose; >12 years weighing ≥50kg: Same as adult dose.
Intramuscular
Uncomplicated gonorrhoea
Adult: In patients with penicillinase-producing and non-penicillinase-producing Neisseria gonorrhoeae strains: 0.25-0.5 g as a single dose. Consideration must be given to local treatment guidelines.
