Susceptible bacterial septicemia, lower respiratory or urinary tract, skin and skin structure, meningitis, bone and joint infections, gonorrhea. Surgical prophylaxis.
Use IV route for serious infections. Usual duration of therapy: 5–10 days. Uncomplicated UTIs, skin and skin structure, disseminated gonorrhea, or uncomplicated pneumonia: 750mg every 8 hours. Severe or complicated infections, bone and joint: 1.5g every 8 hours; life-threatening: 1.5g every 6 hours; meningitis: max 3g every 8 hours. Uncomplicated gonorrhea: 1.5g IM once (divide into 2 injections) with 1g oral probenecid. Prophylaxis: see literature. Renal dysfunction: CrCl 10–20mL/min: 750mg every 12 hours; CrCl <10mL/min: 750mg every 24 hours. Coincide a dose for end of dialysis.
<3 months: not recommended. Give in equally divided doses. ≥3 months: usual range: 50–100mg/kg per day every 6–8 hours. Bone and joint: 150mg/kg per day every 8 hours. Meningitis: 200–240mg/kg per day IV every 6–8 hours. Renal dysfunction: reduce dose.
Penicillin allergy. Renal impairment, reduce dose. Monitor prothrombin time (in patients at risk), renal function. GI disease (esp. colitis). Elderly. Pregnancy (Cat.B). Nursing mothers.
Avoid aminoglycosides, furosemide, ethacrynic acid, other nephrotoxic drugs. May cause false (+) glucose test with Clinitest, Benedict's or Fehling's soln. Potentiated by probenecid.
Local reactions, blood dyscrasias, elevated liver enzymes; rarely: GI upset, rash (may be serious, eg, Stevens-Johnson syndrome), drug fever, anaphylaxis, interstitial nephritis, seizures, hearing loss in children treated for meningitis.