Susceptible infections
Neonate:
All doses are diluted to a concentration not exceeding 18 mg/mL given via IV infusion over 10-60 minutes. Max infusion rate: 30 mg/min.
Alternative dosing recommendation:
All doses may be given via IM inj or diluted to a concentration not exceeding 18 mg/mL given via IV infusion over 10-60 minutes (Max infusion rate: 30 mg/min). Dosage and treatment recommendations may vary among countries or individual products or preparations. Refer to country- or product-specific recommendations.
Postmenstrual Age | Dosage |
≤32 weeks | 5 mg/kg 8 hourly. |
33-40 weeks | 7 mg/kg 8 hourly. |
>40 weeks | 9 mg/kg 8 hourly. |
Alternative dosing recommendation:
Body Weight | Postnatal Age | Dosage |
≤2 kg | ≤28 days | 5 mg/kg 8 hourly. |
>2 kg | ≤7 days | 7 mg/kg 8 hourly. |
8-28 days | 9 mg/kg 8 hourly. |
Intramuscular, Intravenous
Anaerobic infections, Susceptible Gram-positive infections, Susceptible infections
Adult: 600-1,200 mg daily. Severe infections: 1,200-2,700 mg daily, may be increased up to 4,800 mg daily via IV in life-threatening situations. All doses are given in 2-4 equally divided doses. Max: 600 mg (single IM inj); 1,200 mg (single 1-hour IV infusion). IV doses must be infused over at least 10-60 minutes. Max infusion rate: 30 mg/min. For β-haemolytic streptococcal infections: Continue treatment for at least 10 days (to prevent subsequent risk of rheumatic fever or glomerulonephritis). Consideration must be given to local treatment guidelines.
Child: ≥1 month 20-40 mg/kg daily divided into 3 or 4 equal doses. Max: 600 mg (single IM inj). IV doses must be infused over at least 10-60 minutes. Max infusion rate: 30 mg/min. For β-haemolytic streptococcal infections: Continue treatment for at least 10 days (to prevent subsequent risk of rheumatic fever or glomerulonephritis). Dosage and treatment recommendations may vary among countries or individual products or preparations. Refer to country- or product-specific recommendations.
Child: ≥1 month 20-40 mg/kg daily divided into 3 or 4 equal doses. Max: 600 mg (single IM inj). IV doses must be infused over at least 10-60 minutes. Max infusion rate: 30 mg/min. For β-haemolytic streptococcal infections: Continue treatment for at least 10 days (to prevent subsequent risk of rheumatic fever or glomerulonephritis). Dosage and treatment recommendations may vary among countries or individual products or preparations. Refer to country- or product-specific recommendations.
Intravenous
Anthrax
Neonate:
All doses are diluted to a concentration not exceeding 18 mg/mL given via infusion over 10-60 minutes. Max infusion rate: 30 mg/min. Duration of treatment: 2-3 weeks or more until patient becomes stable. Treatment and dosage recommendations may vary among countries or individual products or preparations. Refer to country- or product-specific recommendations.
Gestational Age | Postnatal Age | Dosage |
32-34 weeks | ≤7 days | 5 mg/kg 12 hourly. |
8-28 days | 5 mg/kg 8 hourly. | |
>34 weeks | ≤7 days | 5 mg/kg 8 hourly. |
8-28 days | 5 mg/kg 6 hourly. |
Oral
Susceptible infections
Neonate:
Alternative dosing recommendation:
Dosage and treatment recommendations may vary among countries or individual products or preparations. Refer to country- or product-specific recommendations.
Postmenstrual Age | Dosage |
≤32 weeks | 5 mg/kg 8 hourly. |
33-40 weeks | 7 mg/kg 8 hourly. |
>40 weeks | 9 mg/kg 8 hourly. |
Alternative dosing recommendation:
Body Weight | Postnatal Age | Dosage |
≤2 kg | ≤28 days | 5 mg/kg 8 hourly. |
>2 kg | ≤7 days | 7 mg/kg 8 hourly. |
8-28 days | 9 mg/kg 8 hourly. |
Oral
Anthrax
Neonate:
Duration of treatment: 7-10 days for naturally acquired cutaneous anthrax without systemic involvement; ≥14 days and until patient becomes stable for oral step-down therapy (as part of combination regimen) for severe anthrax; 60 days for postexposure prophylaxis. Treatment and dosage recommendations may vary among countries or individual products or preparations. Refer to country- or product-specific recommendations.
Gestational Age | Postnatal Age | Dosage |
32-34 weeks | ≤7 days | 5 mg/kg 12 hourly. |
8-28 days | 5 mg/kg 8 hourly. | |
>34 weeks | ≤7 days | 5 mg/kg 8 hourly. |
8-28 days | 5 mg/kg 6 hourly. |
Oral
Anaerobic infections, Susceptible Gram-positive infections, Susceptible infections
Adult: As treatment: Moderately severe cases: 150-300 mg 6 hourly. Severe cases: 300-450 mg 6 hourly. For β-haemolytic streptococcal infections: Continue treatment for at least 10 days (to prevent subsequent risk of rheumatic fever or glomerulonephritis). Consideration must be given to local treatment guidelines.
Child: As oral solution: Serious infections: 8-12 mg/kg daily. Severe infections: 13-16 mg/kg daily. More severe infections: 17-25 mg/kg daily. As oral cap: Serious infection: 8-16 mg/kg daily. More severe infections: 16-20 mg/kg daily. All doses are given in 3 or 4 equally divided doses. For β-haemolytic streptococcal infections: Continue treatment for at least 10 days (to prevent subsequent risk of rheumatic fever or glomerulonephritis). Dosage and treatment recommendations may vary among countries or individual products or preparations. Refer to country- or product-specific recommendations.
Child: As oral solution: Serious infections: 8-12 mg/kg daily. Severe infections: 13-16 mg/kg daily. More severe infections: 17-25 mg/kg daily. As oral cap: Serious infection: 8-16 mg/kg daily. More severe infections: 16-20 mg/kg daily. All doses are given in 3 or 4 equally divided doses. For β-haemolytic streptococcal infections: Continue treatment for at least 10 days (to prevent subsequent risk of rheumatic fever or glomerulonephritis). Dosage and treatment recommendations may vary among countries or individual products or preparations. Refer to country- or product-specific recommendations.
Topical/Cutaneous
Acne vulgaris
Adult: As lotion or solution: Apply a thin film to the affected area(s) bid. As gel or foam: Apply a thin film to the affected area(s) once daily. Dosage recommendations may vary among countries or individual products or preparations. Refer to country- or product-specific recommendations.
Vaginal
Bacterial vaginosis
Adult: As 2% cream: Apply 1 applicator full (approx 100 mg) intravaginally at bedtime for 3-7 days. As pessary or ovule: Insert 1 pessary or ovule (100 mg) at bedtime for 3 days. Dosage recommendations may vary among countries or individual products or preparations. Refer to country- or product-specific recommendations.