Intramuscular
Uncomplicated gonorrhoea
Adult: 250-500 mg as a single dose.
Renal impairment:
CrCl (ml/min) | Dosage Recommendation |
<10 | Max: 2 g daily. |
Reconstitution: IM inj: Add 0.9 mL, 1.8 mL, 3.6 mL or 7.2 mL of compatible diluent to vials labelled as containing 250 mg, 500 mg, 1 g and 2 g, respectively, to provide a solution containing approx 250 mg/mL. Alternatively, add 1 mL, 2.1 mL or 4.2 mL of compatible diluent to vials labelled as containing 500 mg, 1 g and 2 g, respectively, to provide a solution containing approx 350 mg/mL.
Incompatibility: Incompatible with Ca-containing solutions or preparations via Y-site (e.g. Ringer's or Hartmann's solution, TPN). Physically incompatible in admixtures with vancomycin, amsacrine, aminoglycosides and fluconazole.
Parenteral
Susceptible infections
Adult: 1-2 g daily, increased to 4 g daily in severe infections, given once or in 2 divided doses via slow IV inj over 5 minutes, or infused over at least 30 minutes, or deep IM inj. Dose >2 g is given via IV inj or infusion.
Child: <15 days 20-50 mg/kg once daily via IV infusion over 60 minutes; 15 days to 12 years weighing <50 kg: 50-80 mg/kg daily, may be increased to 100 mg/kg for severe infections via IV infusion over at least 30 minutes. Max: 4 g daily; >12 years weighing ≥50 kg: Same as adult dose.
Renal impairment:
CrCl (ml/min) | Dosage Recommendation |
<10 | Max: 2 g daily. |
Reconstitution: IM inj: Add 0.9 mL, 1.8 mL, 3.6 mL or 7.2 mL of compatible diluent to vials labelled as containing 250 mg, 500 mg, 1 g and 2 g, respectively, to provide a solution containing approx 250 mg/mL. Alternatively, add 1 mL, 2.1 mL or 4.2 mL of compatible diluent to vials labelled as containing 500 mg, 1 g and 2 g, respectively, to provide a solution containing approx 350 mg/mL. IV inj or infusion: Add 2.4 mL, 4.8 mL, 9.6 mL or 19.2 mL of compatible diluent to vials labelled as containing 250 mg, 500 mg, 1 g and 2 g, respectively, to provide a solution containing approx 100 mg/mL. Further dilute with compatible IV solution to yield solution containing 10-40 mg/mL.
Incompatibility: Incompatible with Ca-containing solutions or preparations via Y-site (e.g. Ringer's or Hartmann's solution, TPN). Physically incompatible in admixtures with vancomycin, amsacrine, aminoglycosides and fluconazole.
Parenteral
Prophylaxis of surgical infections
Adult: 1-2 g as a single dose given 0.5-2 hours before surgery via slow IV inj over 5 minutes, or infused over at least 30 minutes, or deep IM inj.
Child: <15 days 20-50 mg/kg as single pre-operative dose via IV infusion over 60 minutes; 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; >12 years weighing ≥50kg: Same as adult dose.
Renal impairment:
CrCl (ml/min) | Dosage Recommendation |
<10 | Max: 2 g daily. |
Reconstitution: IM inj: Add 0.9 mL, 1.8 mL, 3.6 mL or 7.2 mL of compatible diluent to vials labelled as containing 250 mg, 500 mg, 1 g and 2 g, respectively, to provide a solution containing approx 250 mg/mL. Alternatively, add 1 mL, 2.1 mL or 4.2 mL of compatible diluent to vials labelled as containing 500 mg, 1 g and 2 g, respectively, to provide a solution containing approx 350 mg/mL. IV inj or infusion: Add 2.4 mL, 4.8 mL, 9.6 mL or 19.2 mL of compatible diluent to vials labelled as containing 250 mg, 500 mg, 1 g and 2 g, respectively, to provide a solution containing approx 100 mg/mL. Further dilute with compatible IV solution to yield solution containing 10-40 mg/mL.
Incompatibility: Incompatible with Ca-containing solutions or preparations via Y-site (e.g. Ringer's or Hartmann's solution, TPN). Physically incompatible in admixtures with vancomycin, amsacrine, aminoglycosides and fluconazole.
Parenteral
Syphilis
Adult: 0.5-1 g once daily, increased to 2 g once daily for neurosyphilis for 10-14 days, given via slow IV inj over 5 minutes, or infused over at least 30 minutes, or deep IM inj.
Child: <15 days 50 mg/kg daily via IV infusion over 60 minutes; 15 days to 12 years weighing <50 kg: 75-100 mg/kg daily via IV infusion over at least 30 minutes for 10-14 days. Max: 4 g once daily; >12 years weighing ≥50 kg: Same as adult dose.
Renal impairment:
CrCl (ml/min) | Dosage Recommendation |
<10 | Max: 2 g daily. |
Reconstitution: IM inj: Add 0.9 mL, 1.8 mL, 3.6 mL or 7.2 mL of compatible diluent to vials labelled as containing 250 mg, 500 mg, 1 g and 2 g, respectively, to provide a solution containing approx 250 mg/mL. Alternatively, add 1 mL, 2.1 mL or 4.2 mL of compatible diluent to vials labelled as containing 500 mg, 1 g and 2 g, respectively, to provide a solution containing approx 350 mg/mL. IV inj or infusion: Add 2.4 mL, 4.8 mL, 9.6 mL or 19.2 mL of compatible diluent to vials labelled as containing 250 mg, 500 mg, 1 g and 2 g, respectively, to provide a solution containing approx 100 mg/mL. Further dilute with compatible IV solution to yield solution containing 10-40 mg/mL.
Incompatibility: Incompatible with Ca-containing solutions or preparations via Y-site (e.g. Ringer's or Hartmann's solution, TPN). Physically incompatible in admixtures with vancomycin, amsacrine, aminoglycosides and fluconazole.
Intramuscular
Acute otitis media
Adult: 1-2 g as a single dose.
Child: ≤12 years weighing <50 kg: 50 mg/kg as a single dose; >12 years weighing ≥50kg: Same as adult dose.
Renal impairment:
CrCl (ml/min) | Dosage Recommendation |
<10 | Max: 2 g daily. |
Reconstitution: IM inj: Add 0.9 mL, 1.8 mL, 3.6 mL or 7.2 mL of compatible diluent to vials labelled as containing 250 mg, 500 mg, 1 g and 2 g, respectively, to provide a solution containing approx 250 mg/mL. Alternatively, add 1 mL, 2.1 mL or 4.2 mL of compatible diluent to vials labelled as containing 500 mg, 1 g and 2 g, respectively, to provide a solution containing approx 350 mg/mL.
Incompatibility: Incompatible with Ca-containing solutions or preparations via Y-site (e.g. Ringer's or Hartmann's solution, TPN). Physically incompatible in admixtures with vancomycin, amsacrine, aminoglycosides and fluconazole.
Parenteral
Lyme disease
Adult: 2 g once daily for 14-21 days, given via slow IV inj over 5 minutes, or infused over at least 30 minutes, or deep IM inj.
Child: 15 days to 12 years weighing <50 kg: 50-80 mg/kg once daily for 14-21 days given via IV infusion over at least 30 minutes; >12 years weighing ≥50kg: Same as adult dose.
Renal impairment:
CrCl (ml/min) | Dosage Recommendation |
<10 | Max: 2 g daily. |
Reconstitution: IM inj: Add 0.9 mL, 1.8 mL, 3.6 mL or 7.2 mL of compatible diluent to vials labelled as containing 250 mg, 500 mg, 1 g and 2 g, respectively, to provide a solution containing approx 250 mg/mL. Alternatively, add 1 mL, 2.1 mL or 4.2 mL of compatible diluent to vials labelled as containing 500 mg, 1 g and 2 g, respectively, to provide a solution containing approx 350 mg/mL. IV inj or infusion: Add 2.4 mL, 4.8 mL, 9.6 mL or 19.2 mL of compatible diluent to vials labelled as containing 250 mg, 500 mg, 1 g and 2 g, respectively, to provide a solution containing approx 100 mg/mL. Further dilute with compatible IV solution to yield solution containing 10-40 mg/mL.
Incompatibility: Incompatible with Ca-containing solutions or preparations via Y-site (e.g. Ringer's or Hartmann's solution, TPN). Physically incompatible in admixtures with vancomycin, amsacrine, aminoglycosides and fluconazole.