📋 Indications & Clinical Dosage
*Severe infections of gram-negative or from mixed flora in the presence of gram-negative bacteria, resistant to other antibiotics:*
BY IM OR IV INJ: Adults: 1-2 gm twice daily, adult dose may be doubled if administered by IV. Max 9 gm daily in divided doses. Children & Infants: 50-200 mg/kg/day given in two or more administrations. For neonates (less than 8 days), the drug should be given every 12 hr.
💊 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 with required amount of diluent. Then further dilute in compatible solution. IM: Reconstitute drug with bacteriostatic water for injection (that contains benzyl alcohol or parabens) or SWFI. After reconstitution, let foam dissipate and inspect the solution to ensure complete dissolution.
⚠️ Precautions & Warnings
Prolong use may lead to super infection, may interfere with haemostasis, may cause colitis.
🔄 Drug Interactions
Probenecid, furosemide, aminoglycoside.
⚠️ 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-Johnson syndrome, thrombocytopenia, toxic epidermal necrolysis, transient cholestatic jaundice, transient hepatitis,
🤰 Pregnancy & Lactation Safety
Pregnancy Risk:
Caution advised
Lactation / Breastfeeding:
Caution advised
🧪 Compatibility & Storage Stability
Compatibility: Bacteriostatic water for injection, D5LR, D51/4 NS, D5NS, D5W; D1OW, LR, NS, and SWFI.
Stability & Storage: Prior to reconstitution, store at room temperature.Protect from light. Reconstituted and IV infusion in NS or D5W solution are stable for 24 hours at room temperature , 5 days when refrigerated or 3 weeks, when frozen. After freezing, thawed solution is stable for 48 hours at room tem-perature or ten 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.