Dose can be given by deep IM inj or IV infusion over at least 30 min. AdultMild to moderate infections 1-2 g daily in 2 divided doses. Severe infections 4 g daily in 2 divided doses. Febrile neutropenia Up to 6 g daily in 3 divided doses. Childn >2 mth & weighing 40 kg 50 mg/kg bid or tid (for febrile neutropenia). Renal impairment CrCl 30-60 mL/min 0.5-2 g every 24 hr, 11-29 mL/min 0.5-1 g every 24 hr, ≤10 mL/min 250-500 mg every 24 hr. Patient undergoing hemodialysis Should be given a repeat dose (equiv to initial dose) after each dialysis session. Patient undergoing continuous ambulatory peritoneal dialysis Normal recommended doses at intervals of 48 hr.
Acute renal tubular necrosis w/ excessive dose & in elderly or those w/ preexisting renal impairment or when administered w/ nephrotoxic drugs (eg, aminoglycosides). Possible manifestation of acute interstitial nephritis. Risk of convulsions & other CNS toxicity especially w/ high doses in patients w/ severe renal impairment. Overgrowth of non-susceptible organisms on prolonged use. Pseudomembranous colitis may develop.
Adverse Reactions
Hypersensitivity reactions including skin rashes, urticaria, eosinophilia, fever, serum sickness-like reactions & anaphylaxis. Neutropenia & thrombocytopenia. Bleeding complications related to hypoprothrombinemia &/or platelet dysfunction. Nephrotoxicity. Transient increase in liver enzyme values. Inj site pain following IM use or thrombophlebitis following IV infusion.
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