Susceptible infections
Adult: 25,000-30,000 U/kg daily in divided doses 4-6 hrly. Max: 2,000,000 U/day.
Child: <2 yr 40,000 U/kg daily in divided doses 6 hrly (not routinely recommended due to pain at injection sites); ≥2 yr Same as adult dose but not routinely recommended due to pain at injection sites.
Child: <2 yr 40,000 U/kg daily in divided doses 6 hrly (not routinely recommended due to pain at injection sites); ≥2 yr Same as adult dose but not routinely recommended due to pain at injection sites.
Intrathecal
Meningitis
Adult: 50,000 U once daily for 3-4 days, then on alternate days for at least 2 wk after CSF cultures are negative and CSF glucose content is normal. Max: 2,000,000 U/day.
Child: <2 yr 20,000 U once daily for 3-4 days or 25,000 U on alternate days, followed by the latter dose for at least wk after CSF cultures are negative and CSF glucose content is normal; ≥2 yr Same as adult dose.
Child: <2 yr 20,000 U once daily for 3-4 days or 25,000 U on alternate days, followed by the latter dose for at least wk after CSF cultures are negative and CSF glucose content is normal; ≥2 yr Same as adult dose.
Intravenous
Susceptible infections
Adult: 15,000-25,000 U/kg daily by continuous IV drip or intermittent infusion 12 hrly at 60-120 min duration. Max: 2,000,000 U/day.
Child: <2 yr 40,000 U/kg daily in divided doses 12 hrly; ≥2 yr Same as adult dose.
Child: <2 yr 40,000 U/kg daily in divided doses 12 hrly; ≥2 yr Same as adult dose.
Ophthalmic
Ocular infections
Adult: As soln/oint w/ neomycin and dexamethasone: Soln: Instill 1-2 drops into affected eye up to 6 times daily, may be used hrly in severe cases. Oint: Apply a small amount into the conjunctival sac(s) up to 3-4 times daily.
Child: Same as adult dose.
Child: Same as adult dose.
Otic/Aural
Otic infections
Adult: As otic susp containing 3.5 mg neomycin base, 10,000 U and 10 mg hydrocortisone: Instill 4 drops into the affected ear canal 3-4 times daily for up to 10 days.
Child: As otic susp containing 3.5 mg neomycin base, 10,000 U and 10 mg hydrocortisone: Instill 3 drops into the affected ear canal 3-4 times daily for up to 10 days.
Child: As otic susp containing 3.5 mg neomycin base, 10,000 U and 10 mg hydrocortisone: Instill 3 drops into the affected ear canal 3-4 times daily for up to 10 days.
Subconjunctival
Ocular infections
Adult: Up to 100,000 U daily.
Topical/Cutaneous
Skin infections
Adult: As 0.1% soln or oint in combination other drugs: Apply onto affected area 1-3 times daily.
Child: Same as adult dose.
Child: Same as adult dose.