📋 Indications & Clinical Dosage
*Acute uncomplicated lower urinary-tract infections:*
ORAL SACHET: Adult: 3 g single-dose 1 sachet, mix with 3-4 oz of water.
*Prophylaxis of urinary-tract infections in transurethral surgical procedures:*
ORAL SACHET: Adult: 3 g single-dose 1 sachet, mix with 3-4 oz of water, to be given 3 hours before surgery. Dose maybe repeated once, 24 hours after surgery.
*Osteomyelitis, Hospital-acquired lower respiratory-tract infections when first-line treatments are inappropriate or ineffective:*
ORAL: Adults: 500 mg 6 hourly. Children: 250 mg 6 hourly.
BY IM INJ: Adult: 1 g 8 hourly; Children: 500 mg 8 hourly.
BY IV INF: Adult: 12-24 g daily in 2-3 divided doses (max. per dose 8 g), use the high-dose regimen in severe infection suspected or known to be caused by less sensitive organisms.
Children: half the adult dose; see literature.
*Complicated urinary-tract infections when first-line treatment ineffective or inappropriate:*
ORAL: Adults: 500 mg 6 hourly. Children: 250 mg 6 hourly.
BY IM INJ: Adult: 1 g 8 hourly; Children: 500 mg 8 hourly.
BY IV INF: Adult: 12-16 g daily in 2-3 divided doses (max. per dose 8 g).
Children: half the adult dose; see literature.
*Bacterial meningitis when first-line treatment ineffective or inappropriate:*
ORAL: Adults: 500 mg 6 hourly. Children: 250 mg 6 hourly.
BY IM INJ: Adult: 1 g 8 hourly; Children: 500 mg 8 hourly.
BY IV INF: Adult: 16-24 g daily in 3-4 divided doses (max. per dose 8 g), use the high-dose regimen in severe infection suspected or known to be caused by less sensitive organisms.
Children: half the adult dose; see literature.
💊 Mode of Administration
The-duration of infusion should be at least 15 mins for 2 gm, at least 30 mins for 4 gm and at least 60 mins for 8 gm. Use only clear solutions. As damaging effects can result from inadvertent intra-arterial; administration of products not specifically recommended for intra-arterial therapy. The duration of treatment depends on the individual response of the pathogens and the patients clinical outcome.
⚠️ Precautions & Warnings
Cardiac insufficiency, elderly (high doses), hyperaldosteronism, hypernatraemia, hypertension, pulmonary oedema, renal impairment. With intravenous use, monitor electrolytes and fluid balance
🔄 Drug Interactions
Antacids, metoclopramide and drugs altering GI motility.
⚠️ Adverse Reactions / Side Effects
GI disturbances, diarrhoea, nausea, rash, vomiting, abdominal pain, antibiotic-associated colitis, dizziness, headache, decreased appetite, dyspnea, fatigue, hypernatraemia, hypokalaemia, taste disturbances, vertigo. Rare: Aplastic anaemia, blood disorders, eosinophilia, bronchospasm, confusion, hepatitis, jaundice, tachycardia
🤰 Pregnancy & Lactation Safety
Pregnancy Risk:
Use only if potential benefit outweighs risk.
Lactation / Breastfeeding:
Contraindicated
📚 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.