- Treatment of serious infections due to sensitive anaerobic or gram positive bacteria
- Bacterial endocarditis prophylaxis for dental and upper respiratory procedures in penicillin-allergic patients.
- Stable at room temperature
- Bags available as 12 mg/mL solution
- Solutions Compatible: dextrose up to D10W, 0.9% NaCl, ringer's lactate
- Additives/Above Cassette Compatible: gentamicin, KCl (up to 100 mmol/L)
- Y-site Compatible: morphine, TPN
- Incompatible: aminophylline, tobramycin
(For approved routes of administration by nursing personnel, refer to Policy for the Administration of Intravenous Medications.)
SC | NO |
IM |
YES |
IV Direct |
NO |
IV Intermittent Infusion |
YES |
IV Continuous Infusion | YES |
(For neonatal dosages, refer to Neonatal IV Drug Manual.)
Pediatric:
- 25-30 mg/kg/day IV ÷ Q 8 hours (Maximum: 1800 mg/day)
- Severe Infection: 40 mg/kg/day ÷ Q 6 -8 hours (Maximum: 2700 mg/day) - such as necrotizing fasciitis
- Refer to CHEO guidelines for - Prevention of Bacterial Endocarditis
- Antimicrobials for Surgical Prophylaxis
Adolescent/Adult:
- Usual dose: 1.2-2.7 g/day IV ÷ Q 6-12 hours
Dosing Interval in hepatic impairment:
- Half-life increases in moderate to severe liver dysfunction; dosage reductions are recommended; consult Pharmacy for guidelines.
- Thrombophlebitis, local erythema, pain and swelling may occur at injection site
- Hypersensitivity reactions - urticaria and rash
- Occasional pain or abscess formation after IM injection
- Hypotension and cardiopulmonary arrest may occur during rapid IV administration; infusion rate should not exceed 30 mg/min
- Elevation of serum transaminases, transient leukopenia and eosinophilia
- Clostridium difficile-associated diarrhea and pseudomembranous colitis have occurred
- Does not cross blood-brain barrier even in the presence of inflamed meninges
- Discontinue if severe diarrhea occurs; pseudomembranous colitis may develop even up to several weeks following discontinuation of therapy
- Monitor changes in bowel frequency, CBC, liver and renal function tests