Treatment of polymicrobic & mixed aerobic/anaerobic infections, as well as initial therapy prior to identification of the causative organisms for intra-abdominal, lower resp tract, gynecological, GUT, bone & joint, skin & soft tissue infections, septicemia, & endocarditis (IV formulation only). Effective against anaerobic pathogen Bacteroides fragilis, efficacious against aerobic & anaerobic gm +ve & gm -ve bacteria resistant to cephalosporins & aminoglycosides. Prevention of certain post-op infections.
Dosage/Direction for Use
IV infusionTreatmentAdult ≥70 kg body wt & childn ≥40 kg body wt Most infections: 1-2 g/day in 3-4 divided doses. Moderate infection: 1 g bd. Infections due to less susceptible organisms: May be increased to max 4 g/day or 50 mg/kg/day, whichever is lower. Childn & infant <40 kg body wt 15 mg/kg at 6-hr intervals. Total daily dose: Max 2 g. ProphylaxisAdult 1 g on induction of anesth & 1 g 3 hr later. 2 additional 0.5-g doses can be infused at 8 & 16 hr after induction for high-risk patients.
Contraindications
Hypersensitivity.
Special Precautions
Adjust dosage in renal insufficiency. Partial cross allergenicity w/ other β-lactam antibiotics. History of GI disease, CNS disorders. Decrease dose or discontinue use if CNS symptoms occur. Pregnancy, lactation & childn <3 mth or paed patients w/ impaired renal function.
Adverse Reactions
Erythema, local pain & induration, thrombophlebitis, allergic reactions, GI & haematological disturbances, pseudomembranous colitis, increase in liver enzymes, myoclonic activity, hallucinations, confusional states, seizures, paresthesia, encaphalopathy, agitation, dyskinesia, hearing loss, taste perversion. Drug-related nausea &/or vomiting occur more frequently in granulocytopenic patients.
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