📋 Indications & Clinical Dosage
*Infections due to sensitive Gram-positive and Gram-negative bacteria, Surgical prophylaxis, Haemophilus epiglottitis:*
BY IM INJ, ORIV INJ, OR IV INF: Adult: 1 g every 12 hours
Children: 100-150 mg/kg daily; Neonates, 50 mg/kg daily, in two to four divided doses; max 200 mg/kg daily.
*Severe infections due to sensitive Gram-positive and Gram-negative bacteria, Septicaemia, Meningitis:*
BY IM INJ, ORIV INJ, ORIV INF: Adult: 8 g daily in 4 divided doses, increased ifnecessary to 12 g daily in 3-4 divided doses. IM doses over 1 g should be divided between more than one site.
BY IV INJ: Children: 0-1 week: 50 mg/kg every 12 hr; 1-4 weeks: 50 mg/kg every 8 hr; 1 month-12 yr: less than 50 kg body weight: 50-180 mg/kg/day divided into 4-6 doses.
*Emergency treatment of suspected bacterial meningitis or meningococcal disease, before urgent transfer to hospital:*
BY IV ORIM INJ: Adult & Children above 12 years: 1 g for 1 dose.
Children 1 month-11 years: 50 mg/kg for 1 dose.
*Uncomplicated gonorrhoea:*
BY IM INJ: Adult: 500 mg for 1 dose.
*Bone & joints infection:*
BY IM INJ, ORIV INJ: Adults & Children: above 50 kg body weight: 1-2 gm every 8 hr. Max: 12 gm/day.
BY IV INJ: Children: 0-1 week: 50 mg/kg every 12 hr; 1-4 weeks: 50 mg/kg every 8 hr; 1 month-12 yr: less than 50 kg body weight: 50-180 mg/kg/day divided into 4-6 doses.
💊 Mode of Administration
Inject deep IM into large muscle mass. IV: Inject direct IV over 3-5 min. Infuse intermittent infusion over 30 min. Reconstitute each 0.5, 1, or 2 gm vial with 10 ml of SWFI. Shake to dissolve. For intermittent IV infusion, further dilute in 50-100 ml of D5W or NS. IM: Reconstitute each 500 mg vial with 2 ml SWFI or bacteriostatic water for injection, each 1 gm vial with 3 ml diluent and each 2 gm vial with 5 ml diluent. Shake to dissolve. Compatibility: D5 1/4 NS, 05 1h NS, D5NS, D5W, 010W, LR, NS.
⚠️ Precautions & Warnings
Hypersensitivity, severe renal failure. Monitor blood count if treatment exceeds 10 days.
🔄 Drug Interactions
Loop diuretics, aminoglycosides, probenecid.
⚠️ Adverse Reactions / Side Effects
Abdominal discomfort, agranulocytosis,allergic reactions,anaphylaxis, aplastic anaemia, blood disorders, confusion, disturbances in liver enzymes, dizziness, eosinophilia, haemolytic anaemia, headache, hypertonia, leucopenia, nervousness, pruritus, rashes, fever and arthralgia, sleep disturbances, urticaria, GI disturbances, Rare: Stevens-Johnsonsyndrome, thrombocytopenia, toxic epidermal necrolysis, transient cholestatic jaundice, transient hepatitis
🤰 Pregnancy & Lactation Safety
Pregnancy Risk:
No evidence of harm
Lactation / Breastfeeding:
Caution advised
🧪 Compatibility & Storage Stability
Stability & Storage: Reconstituted solution is stable for 12-34 hours at room temperature and 7-10 days when refrigerated and for 13 weeks when frozen. For IV infusion NS or 05W solution is stable for 24 hours at room temperature, 5 days when refrigerated.
📚 Official Regulatory & Clinical References
- Drug Regulatory Authority of Pakistan (DRAP): Drug Registration, S.R.O. Price Gazettes & National Essential Medicines List (NEML).
- World Health Organization (WHO): Collaborating Centre for Drug Statistics Methodology (ATC/DDD Index).
- Formulary Standards: British National Formulary (BNF) & Pakistan National Formulary (PNF) guidelines.