Indication
- Upper and lower respiratory tract infections, such as acute and chronic bronchitis, pneumonia, sinusitis, otitis media, tonsillitis & pharyngitis.
- Skin & soft tissue structure infections such as peritonitis, wound infections and impetigo.
- Urinary tract infections such as pyelonephritis and cystitis.
- Gonorrhoea
- Septicaemia
- Meningitis and early lyme disease.
- Prophylaxis against infections in abdominal, pelvic, orthopedic, cardiac, pulmonary, oesophageal, & vascular surgery.
Dosage & Administration
Oral:
Adolescents and adults:
Infections | Dosage | Duration (days) |
---|---|---|
Pharyngitis/tonsillitis | 250 mg b.i.d. | 10 |
Acute bacterial maxillary sinusitis | 250 mg b.i.d. | 10 |
Acute bacterial exacerbation of chronic bronchitis | 250-500 mg b.i.d. | 10 |
Secondary bacterial infections of acute bronchitis | 250-500 mg b.i.d. | 5-10 |
Uncomplicated skin and skin structure infections | 250-500 mg b.i.d. | 10 |
Uncomplicated urinary tract infections | 125-250 mg b.i.d. | 7-10 |
Gonorrhoea | 1000 mg once daily | Single dose |
Early Lyme disease | 500 mg b.i.d. | 20 |
MDR Enteric Fever | 500 mg b.i.d. | 14 days |
Children:(over 3 months) Pharyngitis/tonsillitis; 20 mg/day in two divided doses for 10 days. Acute otitis meida, acute bacterial maxillary sinusitis & impetigo: 30 mg / kg /day in two divided doses for 10 days.
Parenteral:
Adults: 750 mg every 6-8 hours; 1.5 g every 6-8 hours. In severe infections: single doses over 750 mg intravenous route only.
Children: usual dose 60 mg / kg daily (range 30-100 mg/kg daily) in 3-4 divided doses (2-3 divided doses in neonates) Prophylaxis: 1.5 g IV/IM with induction of anesthesia followed by 750 mg IM at 8 hours & 16 hours or three times daily for a further 24-48 hours.
Gonorrhoea : 1.5 g as a single dose by intramuscular injection (divided between 2 sites).
Surgical prophylaxix: 1.5 g IV at induction may be supplemented with 750 mg IM every 8 hours for further 24-48 hours (cardiac, pulmonary, oesopheal & vascular operations).
Meningitis: 3g intravenously every 8 hours.
Chlid:200-240 mg/kg daily (in 3-4 divided doses) reduced to 100 mg/kg daily after 3 days or on clinical improvement.
Neonate: 100 mg/kg daily reduced to 50 mg/kg daily.
Preparation of Solutions for Oral Suspension & Intramuscular/Intravenous Injections :
Suspension : Shake the bottle before adding water. Then add 35 ml boiled and cooled water to the bottle to produce 70 ml suspension. Then continue shaking the bottle unit the powder dissolves properly. For 750 mg intramuscular injection: Add 3 ml water for injection BP to vial and then shake gently to dissolve. For 750 mg intravenous injection: Add 6 ml water for injection BP to vial and then shake gently to dissolve.
Contraindications
Patients with known allergy to cephalosporins.
Side effects
Diarrhoea and rarely antibiotic-associated colitis (CSM has warned both more likely with higher doses), nausea and vomiting, abdominal discomfort, headache.
Drug interaction
No potentially hazardous interaction has been reported.
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