Piperacillin Dosage

Usual Adult Dose for Bacteremia

3 to 4 g IV every 4 to 6 hours
Maximum dose: Usually 24 g/day; higher doses have been used

Duration of Therapy:

• Most infections: 7 to 10 days (average)
• Gynecologic infections: 3 to 10 days

Comments:

• Should be administered as a 20- to 30-minute infusion
• Duration of therapy should be guided by clinical and bacteriological progress of patient; some infections (e.g., osteomyelitis) may require significantly longer treatment durations.
• For most acute infections, therapy should continue for at least 48 to 72 hours after patient is asymptomatic.

Uses: For the treatment of serious infections such as septicemia, nosocomial pneumonia, intraabdominal infections, aerobic and anaerobic gynecologic infections, skin and soft tissue infections

• Septicemia (including bacteremia) due to Escherichia coli, Klebsiella species, Enterobacter species, Serratia species, Proteus mirabilis, Streptococcus pneumoniae, enterococci, Pseudomonas aeruginosa, Bacteroides species, or anaerobic cocci
• Lower respiratory tract infections due to E coli, Klebsiella species, Enterobacter species, P aeruginosa, Serratia species, Haemophilus influenzae, Bacteroides species, or anaerobic cocci; although improvement seen in cystic fibrosis patients, may not achieve lasting bacterial eradication
• Intraabdominal infections (including hepatobiliary and surgical infections) due to E coli, P aeruginosa, enterococci, Clostridium species, anaerobic cocci, or Bacteroides species (including Bacteroides fragilis)
• Gynecologic infections (including endometritis, pelvic inflammatory disease, pelvic cellulitis) due to Bacteroides species (including B fragilis), anaerobic cocci, Neisseria gonorrhoeae, or enterococci (Enterococcus faecalis)
• Skin and skin structure infections due to E coli, Klebsiella species, Serratia species, Acinetobacter species, Enterobacter species, P aeruginosa, Morganella morganii, Providencia rettgeri, P vulgaris, P mirabilis, Bacteroides species (including B fragilis), anaerobic cocci, or enterococci
• Bone and joint infections due to P aeruginosa, enterococci, Bacteroides species, or anaerobic cocci

Usual Adult Dose for Intraabdominal Infection

3 to 4 g IV every 4 to 6 hours
Maximum dose: Usually 24 g/day; higher doses have been used

Duration of Therapy:

• Most infections: 7 to 10 days (average)
• Gynecologic infections: 3 to 10 days

Comments:

• Should be administered as a 20- to 30-minute infusion
• Duration of therapy should be guided by clinical and bacteriological progress of patient; some infections (e.g., osteomyelitis) may require significantly longer treatment durations.
• For most acute infections, therapy should continue for at least 48 to 72 hours after patient is asymptomatic.

Uses: For the treatment of serious infections such as septicemia, nosocomial pneumonia, intraabdominal infections, aerobic and anaerobic gynecologic infections, skin and soft tissue infections

• Septicemia (including bacteremia) due to Escherichia coli, Klebsiella species, Enterobacter species, Serratia species, Proteus mirabilis, Streptococcus pneumoniae, enterococci, Pseudomonas aeruginosa, Bacteroides species, or anaerobic cocci
• Lower respiratory tract infections due to E coli, Klebsiella species, Enterobacter species, P aeruginosa, Serratia species, Haemophilus influenzae, Bacteroides species, or anaerobic cocci; although improvement seen in cystic fibrosis patients, may not achieve lasting bacterial eradication
• Intraabdominal infections (including hepatobiliary and surgical infections) due to E coli, P aeruginosa, enterococci, Clostridium species, anaerobic cocci, or Bacteroides species (including Bacteroides fragilis)
• Gynecologic infections (including endometritis, pelvic inflammatory disease, pelvic cellulitis) due to Bacteroides species (including B fragilis), anaerobic cocci, Neisseria gonorrhoeae, or enterococci (Enterococcus faecalis)
• Skin and skin structure infections due to E coli, Klebsiella species, Serratia species, Acinetobacter species, Enterobacter species, P aeruginosa, Morganella morganii, Providencia rettgeri, P vulgaris, P mirabilis, Bacteroides species (including B fragilis), anaerobic cocci, or enterococci
• Bone and joint infections due to P aeruginosa, enterococci, Bacteroides species, or anaerobic cocci

Usual Adult Dose for Joint Infection

3 to 4 g IV every 4 to 6 hours
Maximum dose: Usually 24 g/day; higher doses have been used

Duration of Therapy:

• Most infections: 7 to 10 days (average)
• Gynecologic infections: 3 to 10 days

Comments:

• Should be administered as a 20- to 30-minute infusion
• Duration of therapy should be guided by clinical and bacteriological progress of patient; some infections (e.g., osteomyelitis) may require significantly longer treatment durations.
• For most acute infections, therapy should continue for at least 48 to 72 hours after patient is asymptomatic.

Uses: For the treatment of serious infections such as septicemia, nosocomial pneumonia, intraabdominal infections, aerobic and anaerobic gynecologic infections, skin and soft tissue infections

• Septicemia (including bacteremia) due to Escherichia coli, Klebsiella species, Enterobacter species, Serratia species, Proteus mirabilis, Streptococcus pneumoniae, enterococci, Pseudomonas aeruginosa, Bacteroides species, or anaerobic cocci
• Lower respiratory tract infections due to E coli, Klebsiella species, Enterobacter species, P aeruginosa, Serratia species, Haemophilus influenzae, Bacteroides species, or anaerobic cocci; although improvement seen in cystic fibrosis patients, may not achieve lasting bacterial eradication
• Intraabdominal infections (including hepatobiliary and surgical infections) due to E coli, P aeruginosa, enterococci, Clostridium species, anaerobic cocci, or Bacteroides species (including Bacteroides fragilis)
• Gynecologic infections (including endometritis, pelvic inflammatory disease, pelvic cellulitis) due to Bacteroides species (including B fragilis), anaerobic cocci, Neisseria gonorrhoeae, or enterococci (Enterococcus faecalis)
• Skin and skin structure infections due to E coli, Klebsiella species, Serratia species, Acinetobacter species, Enterobacter species, P aeruginosa, Morganella morganii, Providencia rettgeri, P vulgaris, P mirabilis, Bacteroides species (including B fragilis), anaerobic cocci, or enterococci
• Bone and joint infections due to P aeruginosa, enterococci, Bacteroides species, or anaerobic cocci

Usual Adult Dose for Osteomyelitis

3 to 4 g IV every 4 to 6 hours
Maximum dose: Usually 24 g/day; higher doses have been used

Duration of Therapy:

• Most infections: 7 to 10 days (average)
• Gynecologic infections: 3 to 10 days

Comments:

• Should be administered as a 20- to 30-minute infusion
• Duration of therapy should be guided by clinical and bacteriological progress of patient; some infections (e.g., osteomyelitis) may require significantly longer treatment durations.
• For most acute infections, therapy should continue for at least 48 to 72 hours after patient is asymptomatic.

Uses: For the treatment of serious infections such as septicemia, nosocomial pneumonia, intraabdominal infections, aerobic and anaerobic gynecologic infections, skin and soft tissue infections

• Septicemia (including bacteremia) due to Escherichia coli, Klebsiella species, Enterobacter species, Serratia species, Proteus mirabilis, Streptococcus pneumoniae, enterococci, Pseudomonas aeruginosa, Bacteroides species, or anaerobic cocci
• Lower respiratory tract infections due to E coli, Klebsiella species, Enterobacter species, P aeruginosa, Serratia species, Haemophilus influenzae, Bacteroides species, or anaerobic cocci; although improvement seen in cystic fibrosis patients, may not achieve lasting bacterial eradication
• Intraabdominal infections (including hepatobiliary and surgical infections) due to E coli, P aeruginosa, enterococci, Clostridium species, anaerobic cocci, or Bacteroides species (including Bacteroides fragilis)
• Gynecologic infections (including endometritis, pelvic inflammatory disease, pelvic cellulitis) due to Bacteroides species (including B fragilis), anaerobic cocci, Neisseria gonorrhoeae, or enterococci (Enterococcus faecalis)
• Skin and skin structure infections due to E coli, Klebsiella species, Serratia species, Acinetobacter species, Enterobacter species, P aeruginosa, Morganella morganii, Providencia rettgeri, P vulgaris, P mirabilis, Bacteroides species (including B fragilis), anaerobic cocci, or enterococci
• Bone and joint infections due to P aeruginosa, enterococci, Bacteroides species, or anaerobic cocci

Usual Adult Dose for Pelvic Inflammatory Disease

3 to 4 g IV every 4 to 6 hours
Maximum dose: Usually 24 g/day; higher doses have been used

Duration of Therapy:

• Most infections: 7 to 10 days (average)
• Gynecologic infections: 3 to 10 days

Comments:

• Should be administered as a 20- to 30-minute infusion
• Duration of therapy should be guided by clinical and bacteriological progress of patient; some infections (e.g., osteomyelitis) may require significantly longer treatment durations.
• For most acute infections, therapy should continue for at least 48 to 72 hours after patient is asymptomatic.

Uses: For the treatment of serious infections such as septicemia, nosocomial pneumonia, intraabdominal infections, aerobic and anaerobic gynecologic infections, skin and soft tissue infections

• Septicemia (including bacteremia) due to Escherichia coli, Klebsiella species, Enterobacter species, Serratia species, Proteus mirabilis, Streptococcus pneumoniae, enterococci, Pseudomonas aeruginosa, Bacteroides species, or anaerobic cocci
• Lower respiratory tract infections due to E coli, Klebsiella species, Enterobacter species, P aeruginosa, Serratia species, Haemophilus influenzae, Bacteroides species, or anaerobic cocci; although improvement seen in cystic fibrosis patients, may not achieve lasting bacterial eradication
• Intraabdominal infections (including hepatobiliary and surgical infections) due to E coli, P aeruginosa, enterococci, Clostridium species, anaerobic cocci, or Bacteroides species (including Bacteroides fragilis)
• Gynecologic infections (including endometritis, pelvic inflammatory disease, pelvic cellulitis) due to Bacteroides species (including B fragilis), anaerobic cocci, Neisseria gonorrhoeae, or enterococci (Enterococcus faecalis)
• Skin and skin structure infections due to E coli, Klebsiella species, Serratia species, Acinetobacter species, Enterobacter species, P aeruginosa, Morganella morganii, Providencia rettgeri, P vulgaris, P mirabilis, Bacteroides species (including B fragilis), anaerobic cocci, or enterococci
• Bone and joint infections due to P aeruginosa, enterococci, Bacteroides species, or anaerobic cocci

Usual Adult Dose for Skin or Soft Tissue Infection

3 to 4 g IV every 4 to 6 hours
Maximum dose: Usually 24 g/day; higher doses have been used

Duration of Therapy:

• Most infections: 7 to 10 days (average)
• Gynecologic infections: 3 to 10 days

Comments:

• Should be administered as a 20- to 30-minute infusion
• Duration of therapy should be guided by clinical and bacteriological progress of patient; some infections (e.g., osteomyelitis) may require significantly longer treatment durations.
• For most acute infections, therapy should continue for at least 48 to 72 hours after patient is asymptomatic.

Uses: For the treatment of serious infections such as septicemia, nosocomial pneumonia, intraabdominal infections, aerobic and anaerobic gynecologic infections, skin and soft tissue infections

• Septicemia (including bacteremia) due to Escherichia coli, Klebsiella species, Enterobacter species, Serratia species, Proteus mirabilis, Streptococcus pneumoniae, enterococci, Pseudomonas aeruginosa, Bacteroides species, or anaerobic cocci
• Lower respiratory tract infections due to E coli, Klebsiella species, Enterobacter species, P aeruginosa, Serratia species, Haemophilus influenzae, Bacteroides species, or anaerobic cocci; although improvement seen in cystic fibrosis patients, may not achieve lasting bacterial eradication
• Intraabdominal infections (including hepatobiliary and surgical infections) due to E coli, P aeruginosa, enterococci, Clostridium species, anaerobic cocci, or Bacteroides species (including Bacteroides fragilis)
• Gynecologic infections (including endometritis, pelvic inflammatory disease, pelvic cellulitis) due to Bacteroides species (including B fragilis), anaerobic cocci, Neisseria gonorrhoeae, or enterococci (Enterococcus faecalis)
• Skin and skin structure infections due to E coli, Klebsiella species, Serratia species, Acinetobacter species, Enterobacter species, P aeruginosa, Morganella morganii, Providencia rettgeri, P vulgaris, P mirabilis, Bacteroides species (including B fragilis), anaerobic cocci, or enterococci
• Bone and joint infections due to P aeruginosa, enterococci, Bacteroides species, or anaerobic cocci

Usual Adult Dose for Septicemia

3 to 4 g IV every 4 to 6 hours
Maximum dose: Usually 24 g/day; higher doses have been used

Duration of Therapy:

• Most infections: 7 to 10 days (average)
• Gynecologic infections: 3 to 10 days

Comments:

• Should be administered as a 20- to 30-minute infusion
• Duration of therapy should be guided by clinical and bacteriological progress of patient; some infections (e.g., osteomyelitis) may require significantly longer treatment durations.
• For most acute infections, therapy should continue for at least 48 to 72 hours after patient is asymptomatic.

Uses: For the treatment of serious infections such as septicemia, nosocomial pneumonia, intraabdominal infections, aerobic and anaerobic gynecologic infections, skin and soft tissue infections

• Septicemia (including bacteremia) due to Escherichia coli, Klebsiella species, Enterobacter species, Serratia species, Proteus mirabilis, Streptococcus pneumoniae, enterococci, Pseudomonas aeruginosa, Bacteroides species, or anaerobic cocci
• Lower respiratory tract infections due to E coli, Klebsiella species, Enterobacter species, P aeruginosa, Serratia species, Haemophilus influenzae, Bacteroides species, or anaerobic cocci; although improvement seen in cystic fibrosis patients, may not achieve lasting bacterial eradication
• Intraabdominal infections (including hepatobiliary and surgical infections) due to E coli, P aeruginosa, enterococci, Clostridium species, anaerobic cocci, or Bacteroides species (including Bacteroides fragilis)
• Gynecologic infections (including endometritis, pelvic inflammatory disease, pelvic cellulitis) due to Bacteroides species (including B fragilis), anaerobic cocci, Neisseria gonorrhoeae, or enterococci (Enterococcus faecalis)
• Skin and skin structure infections due to E coli, Klebsiella species, Serratia species, Acinetobacter species, Enterobacter species, P aeruginosa, Morganella morganii, Providencia rettgeri, P vulgaris, P mirabilis, Bacteroides species (including B fragilis), anaerobic cocci, or enterococci
• Bone and joint infections due to P aeruginosa, enterococci, Bacteroides species, or anaerobic cocci

Usual Adult Dose for Bacterial Infection

3 to 4 g IV every 4 to 6 hours
Maximum dose: Usually 24 g/day; higher doses have been used

Duration of Therapy:

• Most infections: 7 to 10 days (average)
• Gynecologic infections: 3 to 10 days

Comments:

• Should be administered as a 20- to 30-minute infusion
• Duration of therapy should be guided by clinical and bacteriological progress of patient; some infections (e.g., osteomyelitis) may require significantly longer treatment durations.
• For most acute infections, therapy should continue for at least 48 to 72 hours after patient is asymptomatic.

Uses: For the treatment of serious infections such as septicemia, nosocomial pneumonia, intraabdominal infections, aerobic and anaerobic gynecologic infections, skin and soft tissue infections

• Septicemia (including bacteremia) due to Escherichia coli, Klebsiella species, Enterobacter species, Serratia species, Proteus mirabilis, Streptococcus pneumoniae, enterococci, Pseudomonas aeruginosa, Bacteroides species, or anaerobic cocci
• Lower respiratory tract infections due to E coli, Klebsiella species, Enterobacter species, P aeruginosa, Serratia species, Haemophilus influenzae, Bacteroides species, or anaerobic cocci; although improvement seen in cystic fibrosis patients, may not achieve lasting bacterial eradication
• Intraabdominal infections (including hepatobiliary and surgical infections) due to E coli, P aeruginosa, enterococci, Clostridium species, anaerobic cocci, or Bacteroides species (including Bacteroides fragilis)
• Gynecologic infections (including endometritis, pelvic inflammatory disease, pelvic cellulitis) due to Bacteroides species (including B fragilis), anaerobic cocci, Neisseria gonorrhoeae, or enterococci (Enterococcus faecalis)
• Skin and skin structure infections due to E coli, Klebsiella species, Serratia species, Acinetobacter species, Enterobacter species, P aeruginosa, Morganella morganii, Providencia rettgeri, P vulgaris, P mirabilis, Bacteroides species (including B fragilis), anaerobic cocci, or enterococci
• Bone and joint infections due to P aeruginosa, enterococci, Bacteroides species, or anaerobic cocci

Usual Adult Dose for Skin and Structure Infection

3 to 4 g IV every 4 to 6 hours
Maximum dose: Usually 24 g/day; higher doses have been used

Duration of Therapy:

• Most infections: 7 to 10 days (average)
• Gynecologic infections: 3 to 10 days

Comments:

• Should be administered as a 20- to 30-minute infusion
• Duration of therapy should be guided by clinical and bacteriological progress of patient; some infections (e.g., osteomyelitis) may require significantly longer treatment durations.
• For most acute infections, therapy should continue for at least 48 to 72 hours after patient is asymptomatic.

Uses: For the treatment of serious infections such as septicemia, nosocomial pneumonia, intraabdominal infections, aerobic and anaerobic gynecologic infections, skin and soft tissue infections

• Septicemia (including bacteremia) due to Escherichia coli, Klebsiella species, Enterobacter species, Serratia species, Proteus mirabilis, Streptococcus pneumoniae, enterococci, Pseudomonas aeruginosa, Bacteroides species, or anaerobic cocci
• Lower respiratory tract infections due to E coli, Klebsiella species, Enterobacter species, P aeruginosa, Serratia species, Haemophilus influenzae, Bacteroides species, or anaerobic cocci; although improvement seen in cystic fibrosis patients, may not achieve lasting bacterial eradication
• Intraabdominal infections (including hepatobiliary and surgical infections) due to E coli, P aeruginosa, enterococci, Clostridium species, anaerobic cocci, or Bacteroides species (including Bacteroides fragilis)
• Gynecologic infections (including endometritis, pelvic inflammatory disease, pelvic cellulitis) due to Bacteroides species (including B fragilis), anaerobic cocci, Neisseria gonorrhoeae, or enterococci (Enterococcus faecalis)
• Skin and skin structure infections due to E coli, Klebsiella species, Serratia species, Acinetobacter species, Enterobacter species, P aeruginosa, Morganella morganii, Providencia rettgeri, P vulgaris, P mirabilis, Bacteroides species (including B fragilis), anaerobic cocci, or enterococci
• Bone and joint infections due to P aeruginosa, enterococci, Bacteroides species, or anaerobic cocci

Usual Adult Dose for Pelvic Infections

3 to 4 g IV every 4 to 6 hours
Maximum dose: Usually 24 g/day; higher doses have been used

Duration of Therapy:

• Most infections: 7 to 10 days (average)
• Gynecologic infections: 3 to 10 days

Comments:

• Should be administered as a 20- to 30-minute infusion
• Duration of therapy should be guided by clinical and bacteriological progress of patient; some infections (e.g., osteomyelitis) may require significantly longer treatment durations.
• For most acute infections, therapy should continue for at least 48 to 72 hours after patient is asymptomatic.

Uses: For the treatment of serious infections such as septicemia, nosocomial pneumonia, intraabdominal infections, aerobic and anaerobic gynecologic infections, skin and soft tissue infections

• Septicemia (including bacteremia) due to Escherichia coli, Klebsiella species, Enterobacter species, Serratia species, Proteus mirabilis, Streptococcus pneumoniae, enterococci, Pseudomonas aeruginosa, Bacteroides species, or anaerobic cocci
• Lower respiratory tract infections due to E coli, Klebsiella species, Enterobacter species, P aeruginosa, Serratia species, Haemophilus influenzae, Bacteroides species, or anaerobic cocci; although improvement seen in cystic fibrosis patients, may not achieve lasting bacterial eradication
• Intraabdominal infections (including hepatobiliary and surgical infections) due to E coli, P aeruginosa, enterococci, Clostridium species, anaerobic cocci, or Bacteroides species (including Bacteroides fragilis)
• Gynecologic infections (including endometritis, pelvic inflammatory disease, pelvic cellulitis) due to Bacteroides species (including B fragilis), anaerobic cocci, Neisseria gonorrhoeae, or enterococci (Enterococcus faecalis)
• Skin and skin structure infections due to E coli, Klebsiella species, Serratia species, Acinetobacter species, Enterobacter species, P aeruginosa, Morganella morganii, Providencia rettgeri, P vulgaris, P mirabilis, Bacteroides species (including B fragilis), anaerobic cocci, or enterococci
• Bone and joint infections due to P aeruginosa, enterococci, Bacteroides species, or anaerobic cocci

Usual Adult Dose for Endometritis

3 to 4 g IV every 4 to 6 hours
Maximum dose: Usually 24 g/day; higher doses have been used

Duration of Therapy:

• Most infections: 7 to 10 days (average)
• Gynecologic infections: 3 to 10 days

Comments:

• Should be administered as a 20- to 30-minute infusion
• Duration of therapy should be guided by clinical and bacteriological progress of patient; some infections (e.g., osteomyelitis) may require significantly longer treatment durations.
• For most acute infections, therapy should continue for at least 48 to 72 hours after patient is asymptomatic.

Uses: For the treatment of serious infections such as septicemia, nosocomial pneumonia, intraabdominal infections, aerobic and anaerobic gynecologic infections, skin and soft tissue infections

• Septicemia (including bacteremia) due to Escherichia coli, Klebsiella species, Enterobacter species, Serratia species, Proteus mirabilis, Streptococcus pneumoniae, enterococci, Pseudomonas aeruginosa, Bacteroides species, or anaerobic cocci
• Lower respiratory tract infections due to E coli, Klebsiella species, Enterobacter species, P aeruginosa, Serratia species, Haemophilus influenzae, Bacteroides species, or anaerobic cocci; although improvement seen in cystic fibrosis patients, may not achieve lasting bacterial eradication
• Intraabdominal infections (including hepatobiliary and surgical infections) due to E coli, P aeruginosa, enterococci, Clostridium species, anaerobic cocci, or Bacteroides species (including Bacteroides fragilis)
• Gynecologic infections (including endometritis, pelvic inflammatory disease, pelvic cellulitis) due to Bacteroides species (including B fragilis), anaerobic cocci, Neisseria gonorrhoeae, or enterococci (Enterococcus faecalis)
• Skin and skin structure infections due to E coli, Klebsiella species, Serratia species, Acinetobacter species, Enterobacter species, P aeruginosa, Morganella morganii, Providencia rettgeri, P vulgaris, P mirabilis, Bacteroides species (including B fragilis), anaerobic cocci, or enterococci
• Bone and joint infections due to P aeruginosa, enterococci, Bacteroides species, or anaerobic cocci

Usual Adult Dose for Nosocomial Pneumonia

3 to 4 g IV every 4 to 6 hours
Maximum dose: Usually 24 g/day; higher doses have been used

Duration of Therapy:

• Most infections: 7 to 10 days (average)
• Gynecologic infections: 3 to 10 days

Comments:

• Should be administered as a 20- to 30-minute infusion
• Duration of therapy should be guided by clinical and bacteriological progress of patient; some infections (e.g., osteomyelitis) may require significantly longer treatment durations.
• For most acute infections, therapy should continue for at least 48 to 72 hours after patient is asymptomatic.

Uses: For the treatment of serious infections such as septicemia, nosocomial pneumonia, intraabdominal infections, aerobic and anaerobic gynecologic infections, skin and soft tissue infections

• Septicemia (including bacteremia) due to Escherichia coli, Klebsiella species, Enterobacter species, Serratia species, Proteus mirabilis, Streptococcus pneumoniae, enterococci, Pseudomonas aeruginosa, Bacteroides species, or anaerobic cocci
• Lower respiratory tract infections due to E coli, Klebsiella species, Enterobacter species, P aeruginosa, Serratia species, Haemophilus influenzae, Bacteroides species, or anaerobic cocci; although improvement seen in cystic fibrosis patients, may not achieve lasting bacterial eradication
• Intraabdominal infections (including hepatobiliary and surgical infections) due to E coli, P aeruginosa, enterococci, Clostridium species, anaerobic cocci, or Bacteroides species (including Bacteroides fragilis)
• Gynecologic infections (including endometritis, pelvic inflammatory disease, pelvic cellulitis) due to Bacteroides species (including B fragilis), anaerobic cocci, Neisseria gonorrhoeae, or enterococci (Enterococcus faecalis)
• Skin and skin structure infections due to E coli, Klebsiella species, Serratia species, Acinetobacter species, Enterobacter species, P aeruginosa, Morganella morganii, Providencia rettgeri, P vulgaris, P mirabilis, Bacteroides species (including B fragilis), anaerobic cocci, or enterococci
• Bone and joint infections due to P aeruginosa, enterococci, Bacteroides species, or anaerobic cocci

Usual Adult Dose for Urinary Tract Infection

Complicated urinary tract infection (UTI): 8 to 16 g/day IV in divided doses every 6 to 8 hours
Uncomplicated UTI: 6 to 8 g/day IM or IV in divided doses every 6 to 12 hours

Duration of therapy: 7 to 10 days (average)

Use: For the treatment of complicated and uncomplicated UTIs due to E coli, Klebsiella species, P aeruginosa, Proteus species (including P mirabilis), or enterococci

Usual Adult Dose for Pneumonia

6 to 8 g/day IM or IV in divided doses every 6 to 12 hours
Duration of therapy: 7 to 10 days (average)

Comments:

• Although improvement has been seen in cystic fibrosis patients, lasting bacterial eradication may not be achieved.

Uses: For the treatment of most community-acquired pneumonia; for the treatment of lower respiratory tract infections due to E coli, Klebsiella species, Enterobacter species, P aeruginosa, Serratia species, H influenzae, Bacteroides species, or anaerobic cocci

Usual Adult Dose for Gonococcal Infection - Uncomplicated

2 g IM once

Comments:

• Probenecid 1 g should be given orally 30 minutes prior to injection.
• Due to resistance, penicillins are not recommended by the US CDC for gonococcal infections.
• Current guidelines should be consulted for additional information.

Use: For the treatment of uncomplicated gonococcal urethritis due to N gonorrhoeae

Usual Adult Dose for Surgical Prophylaxis

Intraabdominal surgery:

• First dose: 2 g IV just prior to surgery
• Second dose: 2 g IV during surgery
• Third dose: 2 g IV every 6 hours postoperatively for up to 24 hours

Use: For prophylactic use in surgery including intraabdominal (gastrointestinal and biliary) procedures

Usual Adult Dose for Cesarean Section

First dose: 2 g IV after cord is clamped
Second dose: 2 g IV 4 hours after the first dose
Third dose: 2 g IV 8 hours after the first dose

Use: For prophylactic use in surgery including cesarean section

Usual Adult Dose for Hysterectomy

Abdominal hysterectomy:

• First dose: 2 g IV just prior to surgery
• Second dose: 2 g IV on return to recovery room
• Third dose: 2 g IV after 6 hours

Vaginal hysterectomy:

• First dose: 2 g IV just prior to surgery
• Second dose: 2 g IV 6 after the first dose
• Third dose: 2 g IV 12 hours after the first dose

Use: For prophylactic use in surgery including abdominal hysterectomy and vaginal hysterectomy

Usual Adult Dose for Pyelonephritis

Some experts recommend: 3 g IV every 6 hours
Duration of therapy: 7 to 14 days

Comments:

• Recommended for the treatment of acute pyelonephritis
• Current guidelines should be consulted for additional information.

Usual Pediatric Dose for Bacteremia

12 years or older: 200 to 300 mg/kg/day IV in divided doses every 4 to 6 hours
Maximum dose: 18 g/day

Duration of Therapy:

• Most infections: 7 to 10 days (average)
• Gynecologic infections: 3 to 10 days

Comments:

• Should be administered as a 20- to 30-minute infusion
• Duration of therapy should be guided by clinical and bacteriological progress of patient; some infections (e.g., osteomyelitis) may require significantly longer treatment durations.
• For most acute infections, therapy should continue for at least 48 to 72 hours after patient is asymptomatic.

Uses: For the treatment of serious infections such as septicemia, nosocomial pneumonia, intraabdominal infections, aerobic and anaerobic gynecologic infections, skin and soft tissue infections

• Septicemia (including bacteremia) due to E coli, Klebsiella species, Enterobacter species, Serratia species, P mirabilis, S pneumoniae, enterococci, P aeruginosa, Bacteroides species, or anaerobic cocci
• Lower respiratory tract infections due to E coli, Klebsiella species, Enterobacter species, P aeruginosa, Serratia species, H influenzae, Bacteroides species, or anaerobic cocci; although improvement seen in cystic fibrosis patients, may not achieve lasting bacterial eradication
• Intraabdominal infections (including hepatobiliary and surgical infections) due to E coli, P aeruginosa, enterococci, Clostridium species, anaerobic cocci, or Bacteroides species (including B fragilis)
• Gynecologic infections (including endometritis, pelvic inflammatory disease, pelvic cellulitis) due to Bacteroides species (including B fragilis), anaerobic cocci, N gonorrhoeae, or enterococci (E faecalis)
• Skin and skin structure infections due to E coli, Klebsiella species, Serratia species, Acinetobacter species, Enterobacter species, P aeruginosa, M morganii, P rettgeri, P vulgaris, P mirabilis, Bacteroides species (including B fragilis), anaerobic cocci, or enterococci
• Bone and joint infections due to P aeruginosa, enterococci, Bacteroides species, or anaerobic cocci

Usual Pediatric Dose for Intraabdominal Infection

12 years or older: 200 to 300 mg/kg/day IV in divided doses every 4 to 6 hours
Maximum dose: 18 g/day

Duration of Therapy:

• Most infections: 7 to 10 days (average)
• Gynecologic infections: 3 to 10 days

Comments:

• Should be administered as a 20- to 30-minute infusion
• Duration of therapy should be guided by clinical and bacteriological progress of patient; some infections (e.g., osteomyelitis) may require significantly longer treatment durations.
• For most acute infections, therapy should continue for at least 48 to 72 hours after patient is asymptomatic.

Uses: For the treatment of serious infections such as septicemia, nosocomial pneumonia, intraabdominal infections, aerobic and anaerobic gynecologic infections, skin and soft tissue infections

• Septicemia (including bacteremia) due to E coli, Klebsiella species, Enterobacter species, Serratia species, P mirabilis, S pneumoniae, enterococci, P aeruginosa, Bacteroides species, or anaerobic cocci
• Lower respiratory tract infections due to E coli, Klebsiella species, Enterobacter species, P aeruginosa, Serratia species, H influenzae, Bacteroides species, or anaerobic cocci; although improvement seen in cystic fibrosis patients, may not achieve lasting bacterial eradication
• Intraabdominal infections (including hepatobiliary and surgical infections) due to E coli, P aeruginosa, enterococci, Clostridium species, anaerobic cocci, or Bacteroides species (including B fragilis)
• Gynecologic infections (including endometritis, pelvic inflammatory disease, pelvic cellulitis) due to Bacteroides species (including B fragilis), anaerobic cocci, N gonorrhoeae, or enterococci (E faecalis)
• Skin and skin structure infections due to E coli, Klebsiella species, Serratia species, Acinetobacter species, Enterobacter species, P aeruginosa, M morganii, P rettgeri, P vulgaris, P mirabilis, Bacteroides species (including B fragilis), anaerobic cocci, or enterococci
• Bone and joint infections due to P aeruginosa, enterococci, Bacteroides species, or anaerobic cocci

Usual Pediatric Dose for Joint Infection

12 years or older: 200 to 300 mg/kg/day IV in divided doses every 4 to 6 hours
Maximum dose: 18 g/day

Duration of Therapy:

• Most infections: 7 to 10 days (average)
• Gynecologic infections: 3 to 10 days

Comments:

• Should be administered as a 20- to 30-minute infusion
• Duration of therapy should be guided by clinical and bacteriological progress of patient; some infections (e.g., osteomyelitis) may require significantly longer treatment durations.
• For most acute infections, therapy should continue for at least 48 to 72 hours after patient is asymptomatic.

Uses: For the treatment of serious infections such as septicemia, nosocomial pneumonia, intraabdominal infections, aerobic and anaerobic gynecologic infections, skin and soft tissue infections

• Septicemia (including bacteremia) due to E coli, Klebsiella species, Enterobacter species, Serratia species, P mirabilis, S pneumoniae, enterococci, P aeruginosa, Bacteroides species, or anaerobic cocci
• Lower respiratory tract infections due to E coli, Klebsiella species, Enterobacter species, P aeruginosa, Serratia species, H influenzae, Bacteroides species, or anaerobic cocci; although improvement seen in cystic fibrosis patients, may not achieve lasting bacterial eradication
• Intraabdominal infections (including hepatobiliary and surgical infections) due to E coli, P aeruginosa, enterococci, Clostridium species, anaerobic cocci, or Bacteroides species (including B fragilis)
• Gynecologic infections (including endometritis, pelvic inflammatory disease, pelvic cellulitis) due to Bacteroides species (including B fragilis), anaerobic cocci, N gonorrhoeae, or enterococci (E faecalis)
• Skin and skin structure infections due to E coli, Klebsiella species, Serratia species, Acinetobacter species, Enterobacter species, P aeruginosa, M morganii, P rettgeri, P vulgaris, P mirabilis, Bacteroides species (including B fragilis), anaerobic cocci, or enterococci
• Bone and joint infections due to P aeruginosa, enterococci, Bacteroides species, or anaerobic cocci

Usual Pediatric Dose for Osteomyelitis

12 years or older: 200 to 300 mg/kg/day IV in divided doses every 4 to 6 hours
Maximum dose: 18 g/day

Duration of Therapy:

• Most infections: 7 to 10 days (average)
• Gynecologic infections: 3 to 10 days

Comments:

• Should be administered as a 20- to 30-minute infusion
• Duration of therapy should be guided by clinical and bacteriological progress of patient; some infections (e.g., osteomyelitis) may require significantly longer treatment durations.
• For most acute infections, therapy should continue for at least 48 to 72 hours after patient is asymptomatic.

Uses: For the treatment of serious infections such as septicemia, nosocomial pneumonia, intraabdominal infections, aerobic and anaerobic gynecologic infections, skin and soft tissue infections

• Septicemia (including bacteremia) due to E coli, Klebsiella species, Enterobacter species, Serratia species, P mirabilis, S pneumoniae, enterococci, P aeruginosa, Bacteroides species, or anaerobic cocci
• Lower respiratory tract infections due to E coli, Klebsiella species, Enterobacter species, P aeruginosa, Serratia species, H influenzae, Bacteroides species, or anaerobic cocci; although improvement seen in cystic fibrosis patients, may not achieve lasting bacterial eradication
• Intraabdominal infections (including hepatobiliary and surgical infections) due to E coli, P aeruginosa, enterococci, Clostridium species, anaerobic cocci, or Bacteroides species (including B fragilis)
• Gynecologic infections (including endometritis, pelvic inflammatory disease, pelvic cellulitis) due to Bacteroides species (including B fragilis), anaerobic cocci, N gonorrhoeae, or enterococci (E faecalis)
• Skin and skin structure infections due to E coli, Klebsiella species, Serratia species, Acinetobacter species, Enterobacter species, P aeruginosa, M morganii, P rettgeri, P vulgaris, P mirabilis, Bacteroides species (including B fragilis), anaerobic cocci, or enterococci
• Bone and joint infections due to P aeruginosa, enterococci, Bacteroides species, or anaerobic cocci

Usual Pediatric Dose for Pelvic Inflammatory Disease

12 years or older: 200 to 300 mg/kg/day IV in divided doses every 4 to 6 hours
Maximum dose: 18 g/day

Duration of Therapy:

• Most infections: 7 to 10 days (average)
• Gynecologic infections: 3 to 10 days

Comments:

• Should be administered as a 20- to 30-minute infusion
• Duration of therapy should be guided by clinical and bacteriological progress of patient; some infections (e.g., osteomyelitis) may require significantly longer treatment durations.
• For most acute infections, therapy should continue for at least 48 to 72 hours after patient is asymptomatic.

Uses: For the treatment of serious infections such as septicemia, nosocomial pneumonia, intraabdominal infections, aerobic and anaerobic gynecologic infections, skin and soft tissue infections

• Septicemia (including bacteremia) due to E coli, Klebsiella species, Enterobacter species, Serratia species, P mirabilis, S pneumoniae, enterococci, P aeruginosa, Bacteroides species, or anaerobic cocci
• Lower respiratory tract infections due to E coli, Klebsiella species, Enterobacter species, P aeruginosa, Serratia species, H influenzae, Bacteroides species, or anaerobic cocci; although improvement seen in cystic fibrosis patients, may not achieve lasting bacterial eradication
• Intraabdominal infections (including hepatobiliary and surgical infections) due to E coli, P aeruginosa, enterococci, Clostridium species, anaerobic cocci, or Bacteroides species (including B fragilis)
• Gynecologic infections (including endometritis, pelvic inflammatory disease, pelvic cellulitis) due to Bacteroides species (including B fragilis), anaerobic cocci, N gonorrhoeae, or enterococci (E faecalis)
• Skin and skin structure infections due to E coli, Klebsiella species, Serratia species, Acinetobacter species, Enterobacter species, P aeruginosa, M morganii, P rettgeri, P vulgaris, P mirabilis, Bacteroides species (including B fragilis), anaerobic cocci, or enterococci
• Bone and joint infections due to P aeruginosa, enterococci, Bacteroides species, or anaerobic cocci

Usual Pediatric Dose for Skin or Soft Tissue Infection

12 years or older: 200 to 300 mg/kg/day IV in divided doses every 4 to 6 hours
Maximum dose: 18 g/day

Duration of Therapy:

• Most infections: 7 to 10 days (average)
• Gynecologic infections: 3 to 10 days

Comments:

• Should be administered as a 20- to 30-minute infusion
• Duration of therapy should be guided by clinical and bacteriological progress of patient; some infections (e.g., osteomyelitis) may require significantly longer treatment durations.
• For most acute infections, therapy should continue for at least 48 to 72 hours after patient is asymptomatic.

Uses: For the treatment of serious infections such as septicemia, nosocomial pneumonia, intraabdominal infections, aerobic and anaerobic gynecologic infections, skin and soft tissue infections

• Septicemia (including bacteremia) due to E coli, Klebsiella species, Enterobacter species, Serratia species, P mirabilis, S pneumoniae, enterococci, P aeruginosa, Bacteroides species, or anaerobic cocci
• Lower respiratory tract infections due to E coli, Klebsiella species, Enterobacter species, P aeruginosa, Serratia species, H influenzae, Bacteroides species, or anaerobic cocci; although improvement seen in cystic fibrosis patients, may not achieve lasting bacterial eradication
• Intraabdominal infections (including hepatobiliary and surgical infections) due to E coli, P aeruginosa, enterococci, Clostridium species, anaerobic cocci, or Bacteroides species (including B fragilis)
• Gynecologic infections (including endometritis, pelvic inflammatory disease, pelvic cellulitis) due to Bacteroides species (including B fragilis), anaerobic cocci, N gonorrhoeae, or enterococci (E faecalis)
• Skin and skin structure infections due to E coli, Klebsiella species, Serratia species, Acinetobacter species, Enterobacter species, P aeruginosa, M morganii, P rettgeri, P vulgaris, P mirabilis, Bacteroides species (including B fragilis), anaerobic cocci, or enterococci
• Bone and joint infections due to P aeruginosa, enterococci, Bacteroides species, or anaerobic cocci

Usual Pediatric Dose for Septicemia

12 years or older: 200 to 300 mg/kg/day IV in divided doses every 4 to 6 hours
Maximum dose: 18 g/day

Duration of Therapy:

• Most infections: 7 to 10 days (average)
• Gynecologic infections: 3 to 10 days

Comments:

• Should be administered as a 20- to 30-minute infusion
• Duration of therapy should be guided by clinical and bacteriological progress of patient; some infections (e.g., osteomyelitis) may require significantly longer treatment durations.
• For most acute infections, therapy should continue for at least 48 to 72 hours after patient is asymptomatic.

Uses: For the treatment of serious infections such as septicemia, nosocomial pneumonia, intraabdominal infections, aerobic and anaerobic gynecologic infections, skin and soft tissue infections

• Septicemia (including bacteremia) due to E coli, Klebsiella species, Enterobacter species, Serratia species, P mirabilis, S pneumoniae, enterococci, P aeruginosa, Bacteroides species, or anaerobic cocci
• Lower respiratory tract infections due to E coli, Klebsiella species, Enterobacter species, P aeruginosa, Serratia species, H influenzae, Bacteroides species, or anaerobic cocci; although improvement seen in cystic fibrosis patients, may not achieve lasting bacterial eradication
• Intraabdominal infections (including hepatobiliary and surgical infections) due to E coli, P aeruginosa, enterococci, Clostridium species, anaerobic cocci, or Bacteroides species (including B fragilis)
• Gynecologic infections (including endometritis, pelvic inflammatory disease, pelvic cellulitis) due to Bacteroides species (including B fragilis), anaerobic cocci, N gonorrhoeae, or enterococci (E faecalis)
• Skin and skin structure infections due to E coli, Klebsiella species, Serratia species, Acinetobacter species, Enterobacter species, P aeruginosa, M morganii, P rettgeri, P vulgaris, P mirabilis, Bacteroides species (including B fragilis), anaerobic cocci, or enterococci
• Bone and joint infections due to P aeruginosa, enterococci, Bacteroides species, or anaerobic cocci

Usual Pediatric Dose for Bacterial Infection

12 years or older: 200 to 300 mg/kg/day IV in divided doses every 4 to 6 hours
Maximum dose: 18 g/day

Duration of Therapy:

• Most infections: 7 to 10 days (average)
• Gynecologic infections: 3 to 10 days

Comments:

• Should be administered as a 20- to 30-minute infusion
• Duration of therapy should be guided by clinical and bacteriological progress of patient; some infections (e.g., osteomyelitis) may require significantly longer treatment durations.
• For most acute infections, therapy should continue for at least 48 to 72 hours after patient is asymptomatic.

Uses: For the treatment of serious infections such as septicemia, nosocomial pneumonia, intraabdominal infections, aerobic and anaerobic gynecologic infections, skin and soft tissue infections

• Septicemia (including bacteremia) due to E coli, Klebsiella species, Enterobacter species, Serratia species, P mirabilis, S pneumoniae, enterococci, P aeruginosa, Bacteroides species, or anaerobic cocci
• Lower respiratory tract infections due to E coli, Klebsiella species, Enterobacter species, P aeruginosa, Serratia species, H influenzae, Bacteroides species, or anaerobic cocci; although improvement seen in cystic fibrosis patients, may not achieve lasting bacterial eradication
• Intraabdominal infections (including hepatobiliary and surgical infections) due to E coli, P aeruginosa, enterococci, Clostridium species, anaerobic cocci, or Bacteroides species (including B fragilis)
• Gynecologic infections (including endometritis, pelvic inflammatory disease, pelvic cellulitis) due to Bacteroides species (including B fragilis), anaerobic cocci, N gonorrhoeae, or enterococci (E faecalis)
• Skin and skin structure infections due to E coli, Klebsiella species, Serratia species, Acinetobacter species, Enterobacter species, P aeruginosa, M morganii, P rettgeri, P vulgaris, P mirabilis, Bacteroides species (including B fragilis), anaerobic cocci, or enterococci
• Bone and joint infections due to P aeruginosa, enterococci, Bacteroides species, or anaerobic cocci

Usual Pediatric Dose for Skin and Structure Infection

12 years or older: 200 to 300 mg/kg/day IV in divided doses every 4 to 6 hours
Maximum dose: 18 g/day

Duration of Therapy:

• Most infections: 7 to 10 days (average)
• Gynecologic infections: 3 to 10 days

Comments:

• Should be administered as a 20- to 30-minute infusion
• Duration of therapy should be guided by clinical and bacteriological progress of patient; some infections (e.g., osteomyelitis) may require significantly longer treatment durations.
• For most acute infections, therapy should continue for at least 48 to 72 hours after patient is asymptomatic.

Uses: For the treatment of serious infections such as septicemia, nosocomial pneumonia, intraabdominal infections, aerobic and anaerobic gynecologic infections, skin and soft tissue infections

• Septicemia (including bacteremia) due to E coli, Klebsiella species, Enterobacter species, Serratia species, P mirabilis, S pneumoniae, enterococci, P aeruginosa, Bacteroides species, or anaerobic cocci
• Lower respiratory tract infections due to E coli, Klebsiella species, Enterobacter species, P aeruginosa, Serratia species, H influenzae, Bacteroides species, or anaerobic cocci; although improvement seen in cystic fibrosis patients, may not achieve lasting bacterial eradication
• Intraabdominal infections (including hepatobiliary and surgical infections) due to E coli, P aeruginosa, enterococci, Clostridium species, anaerobic cocci, or Bacteroides species (including B fragilis)
• Gynecologic infections (including endometritis, pelvic inflammatory disease, pelvic cellulitis) due to Bacteroides species (including B fragilis), anaerobic cocci, N gonorrhoeae, or enterococci (E faecalis)
• Skin and skin structure infections due to E coli, Klebsiella species, Serratia species, Acinetobacter species, Enterobacter species, P aeruginosa, M morganii, P rettgeri, P vulgaris, P mirabilis, Bacteroides species (including B fragilis), anaerobic cocci, or enterococci
• Bone and joint infections due to P aeruginosa, enterococci, Bacteroides species, or anaerobic cocci

Usual Pediatric Dose for Pelvic Infections

12 years or older: 200 to 300 mg/kg/day IV in divided doses every 4 to 6 hours
Maximum dose: 18 g/day

Duration of Therapy:

• Most infections: 7 to 10 days (average)
• Gynecologic infections: 3 to 10 days

Comments:

• Should be administered as a 20- to 30-minute infusion
• Duration of therapy should be guided by clinical and bacteriological progress of patient; some infections (e.g., osteomyelitis) may require significantly longer treatment durations.
• For most acute infections, therapy should continue for at least 48 to 72 hours after patient is asymptomatic.

Uses: For the treatment of serious infections such as septicemia, nosocomial pneumonia, intraabdominal infections, aerobic and anaerobic gynecologic infections, skin and soft tissue infections

• Septicemia (including bacteremia) due to E coli, Klebsiella species, Enterobacter species, Serratia species, P mirabilis, S pneumoniae, enterococci, P aeruginosa, Bacteroides species, or anaerobic cocci
• Lower respiratory tract infections due to E coli, Klebsiella species, Enterobacter species, P aeruginosa, Serratia species, H influenzae, Bacteroides species, or anaerobic cocci; although improvement seen in cystic fibrosis patients, may not achieve lasting bacterial eradication
• Intraabdominal infections (including hepatobiliary and surgical infections) due to E coli, P aeruginosa, enterococci, Clostridium species, anaerobic cocci, or Bacteroides species (including B fragilis)
• Gynecologic infections (including endometritis, pelvic inflammatory disease, pelvic cellulitis) due to Bacteroides species (including B fragilis), anaerobic cocci, N gonorrhoeae, or enterococci (E faecalis)
• Skin and skin structure infections due to E coli, Klebsiella species, Serratia species, Acinetobacter species, Enterobacter species, P aeruginosa, M morganii, P rettgeri, P vulgaris, P mirabilis, Bacteroides species (including B fragilis), anaerobic cocci, or enterococci
• Bone and joint infections due to P aeruginosa, enterococci, Bacteroides species, or anaerobic cocci

Usual Pediatric Dose for Endometritis

12 years or older: 200 to 300 mg/kg/day IV in divided doses every 4 to 6 hours
Maximum dose: 18 g/day

Duration of Therapy:

• Most infections: 7 to 10 days (average)
• Gynecologic infections: 3 to 10 days

Comments:

• Should be administered as a 20- to 30-minute infusion
• Duration of therapy should be guided by clinical and bacteriological progress of patient; some infections (e.g., osteomyelitis) may require significantly longer treatment durations.
• For most acute infections, therapy should continue for at least 48 to 72 hours after patient is asymptomatic.

Uses: For the treatment of serious infections such as septicemia, nosocomial pneumonia, intraabdominal infections, aerobic and anaerobic gynecologic infections, skin and soft tissue infections

• Septicemia (including bacteremia) due to E coli, Klebsiella species, Enterobacter species, Serratia species, P mirabilis, S pneumoniae, enterococci, P aeruginosa, Bacteroides species, or anaerobic cocci
• Lower respiratory tract infections due to E coli, Klebsiella species, Enterobacter species, P aeruginosa, Serratia species, H influenzae, Bacteroides species, or anaerobic cocci; although improvement seen in cystic fibrosis patients, may not achieve lasting bacterial eradication
• Intraabdominal infections (including hepatobiliary and surgical infections) due to E coli, P aeruginosa, enterococci, Clostridium species, anaerobic cocci, or Bacteroides species (including B fragilis)
• Gynecologic infections (including endometritis, pelvic inflammatory disease, pelvic cellulitis) due to Bacteroides species (including B fragilis), anaerobic cocci, N gonorrhoeae, or enterococci (E faecalis)
• Skin and skin structure infections due to E coli, Klebsiella species, Serratia species, Acinetobacter species, Enterobacter species, P aeruginosa, M morganii, P rettgeri, P vulgaris, P mirabilis, Bacteroides species (including B fragilis), anaerobic cocci, or enterococci
• Bone and joint infections due to P aeruginosa, enterococci, Bacteroides species, or anaerobic cocci

Usual Pediatric Dose for Nosocomial Pneumonia

12 years or older: 200 to 300 mg/kg/day IV in divided doses every 4 to 6 hours
Maximum dose: 18 g/day

Duration of Therapy:

• Most infections: 7 to 10 days (average)
• Gynecologic infections: 3 to 10 days

Comments:

• Should be administered as a 20- to 30-minute infusion
• Duration of therapy should be guided by clinical and bacteriological progress of patient; some infections (e.g., osteomyelitis) may require significantly longer treatment durations.
• For most acute infections, therapy should continue for at least 48 to 72 hours after patient is asymptomatic.

Uses: For the treatment of serious infections such as septicemia, nosocomial pneumonia, intraabdominal infections, aerobic and anaerobic gynecologic infections, skin and soft tissue infections

• Septicemia (including bacteremia) due to E coli, Klebsiella species, Enterobacter species, Serratia species, P mirabilis, S pneumoniae, enterococci, P aeruginosa, Bacteroides species, or anaerobic cocci
• Lower respiratory tract infections due to E coli, Klebsiella species, Enterobacter species, P aeruginosa, Serratia species, H influenzae, Bacteroides species, or anaerobic cocci; although improvement seen in cystic fibrosis patients, may not achieve lasting bacterial eradication
• Intraabdominal infections (including hepatobiliary and surgical infections) due to E coli, P aeruginosa, enterococci, Clostridium species, anaerobic cocci, or Bacteroides species (including B fragilis)
• Gynecologic infections (including endometritis, pelvic inflammatory disease, pelvic cellulitis) due to Bacteroides species (including B fragilis), anaerobic cocci, N gonorrhoeae, or enterococci (E faecalis)
• Skin and skin structure infections due to E coli, Klebsiella species, Serratia species, Acinetobacter species, Enterobacter species, P aeruginosa, M morganii, P rettgeri, P vulgaris, P mirabilis, Bacteroides species (including B fragilis), anaerobic cocci, or enterococci
• Bone and joint infections due to P aeruginosa, enterococci, Bacteroides species, or anaerobic cocci

Usual Pediatric Dose for Urinary Tract Infection

12 years or older:
Complicated UTI: 125 to 200 mg/kg/day IV in divided doses every 6 to 8 hours
Maximum dose: 16 g/day

Uncomplicated UTI: 100 to 125 mg/kg/day IM or IV in divided doses every 6 to 12 hours
Maximum dose: 8 g/day

Duration of therapy: 7 to 10 days (average)

Use: For the treatment of complicated and uncomplicated UTIs due to E coli, Klebsiella species, P aeruginosa, Proteus species (including P mirabilis), or enterococci

Usual Pediatric Dose for Pneumonia

12 years or older: 100 to 125 mg/kg/day IM or IV in divided doses every 6 to 12 hours
Maximum dose: 8 g/day
Duration of therapy: 7 to 10 days (average)

Comments:

• Although improvement has been seen in cystic fibrosis patients, lasting bacterial eradication may not be achieved.

Uses: For the treatment of most community-acquired pneumonia; for the treatment of lower respiratory tract infections due to E coli, Klebsiella species, Enterobacter species, P aeruginosa, Serratia species, H influenzae, Bacteroides species, or anaerobic cocci

Usual Pediatric Dose for Gonococcal Infection - Uncomplicated

12 years or older: 2 g IM once

Comments:

• Probenecid 1 g should be given orally 30 minutes prior to injection.
• Due to resistance, penicillins are not recommended by the US CDC for gonococcal infections.
• Current guidelines should be consulted for additional information.

Use: For the treatment of uncomplicated gonococcal urethritis due to N gonorrhoeae

Renal Dose Adjustments

Adults:
CrCl 20 to 40 mL/min:

• Complicated UTI: 3 g IV every 8 hours
• Uncomplicated UTI: No adjustment recommended.
• Severe systemic infection: 4 g IV every 8 hours

CrCl less than 20 mL/min:

• Complicated or uncomplicated UTI: 3 g IV every 12 hours
• Severe systemic infection: 4 g IV every 12 hours

Comments:

• For patients with renal failure, measurement of serum drug levels will provide additional guidance for adjusting dose.

Liver Dose Adjustments

Data not available

Comments:

• For patients with liver dysfunction, measurement of serum drug levels will provide additional guidance for adjusting dose.

Precautions

Safety and efficacy have not been established in patients younger than 12 years.

Consult WARNINGS section for additional precautions.

Dialysis

Adults:
Hemodialysis:

• Severe systemic infection: 2 g IV every 8 hours

Comments:

• Because hemodialysis removes 30% to 50% of this drug in 4 hours, a supplemental dose of 1 g should be administered after each dialysis period.

Other Comments

Administration advice:

• May administer by IM injection, IV injection, or IV infusion; use IV route for serious infections.
• Administer IV injection slowly over 3 to 5 minutes (to help avoid vein irritation); administer IV infusion over about 20 to 40 minutes (or intermittent infusion over 30-minute to 2-hour period); discontinue primary IV solution during infusion of this drug.
• Limit IM injections to 2 g per injection site; this route of administration used primarily in the treatment of uncomplicated gonorrhea and urinary tract infections.
• When indicated by clinical and bacteriological findings, may start therapy with 6 to 8 g/day IM (in divided doses); may consider IM administration for maintenance therapy after clinical and bacteriological improvement obtained with IV therapy
• Upper outer quadrant of the buttock (i.e., gluteus maximus) is preferred site for IM injection; use deltoid area with caution only if well-developed (to avoid radial nerve injury); do not make IM injection into the lower or mid-third of the upper arm.
• Maximum adult dose usually 24 g/day; higher doses have been used.
• Duration of therapy for most infections average 7 to 10 days; duration of therapy for gynecologic infections 3 to 10 days; treatment duration should be guided by clinical and bacteriological progress of patient; some infections (e.g., osteomyelitis) may require significantly longer treatment durations.
• For most acute infections, continue therapy for at least 48 to 72 hours after patient is asymptomatic.
• Maintain antibiotic therapy for S pyogenes (group A beta-hemolytic streptococcal infections) for at least 10 days to reduce risk of rheumatic fever or glomerulonephritis.
• For prophylaxis, administer as 20- to 30-minute infusion just prior to anesthesia (when possible); administration while patient is awake will aid detection of possible side effects during drug infusion.
• Effective prophylactic use depends on time of administration; administer 30 to 60 minutes before surgery so effective levels can be reached in the site before the procedure.
• Stop prophylactic use within 24 hours as continued antibiotic use increases risk of side effects but does not reduce rate of subsequent infections (in most surgical procedures).
• If coadminister with aminoglycoside, use both drugs in full therapeutic doses; use of this drug with aminoglycosides has been successful, particularly in patients with impaired host defenses.

Storage requirements:

• Vials: Store between 15C and 30C (between 59F and 86F).

Reconstitution/preparation techniques:

• The manufacturer product information should be consulted.

IV compatibility:

• Compatible diluents and IV solutions: Sterile Water for Injection, USP; 5% Dextrose Injection, USP; 0.9% Sodium Chloride Injection, USP; 5% Dextrose and 0.9% Sodium Chloride Injection, USP; Lactated Ringer's Injection, USP
• Incompatible: Solutions containing only sodium bicarbonate; blood products

General:

• This drug is for the treatment of serious infections due to susceptible strains of the designated bacteria.
• Culture and susceptibility information should be considered when selecting/modifying antibacterial therapy or, if no data are available, local epidemiology and susceptibility patterns may be considered when selecting empiric therapy.
• Appropriate culture and susceptibility testing recommended before therapy to isolate and identify infecting organisms and to establish susceptibility to this drug. Therapy may be started before test results are known; appropriate therapy should be continued when results are available.
• This drug is clinically effective for the treatment of infections at various sites due to Streptococcus species (including S pyogenes, S pneumoniae), but such infections are normally treated with more narrow-spectrum penicillins; because of its broad spectrum of bactericidal activity against gram-positive and gram-negative aerobic and anaerobic bacteria, this drug is especially useful for the treatment of mixed infections and as presumptive therapy before the causative organisms are identified.
• This drug may be used as single drug therapy in some situations where 2 antibiotics might typically be used.
• Sodium content is about 1.85 mEq (42.5 mg) per gram of drug; at usual recommended doses, patients would receive about 11.1 to 33.3 mEq/day (255 to 765 mg/day) of sodium.

Monitoring:

• Cardiovascular: Cardiac status in patients with impaired cardiac function (during prolonged therapy)
• General: Drug serum levels in patients with renal failure, liver dysfunction, or biliary tract obstruction; organ system function (periodically during prolonged therapy)
• Hematologic: Hematopoietic system function (periodically during prolonged therapy)
• Hepatic: Hepatic system function (periodically during prolonged therapy)
• Infections/Infestations: Syphilis serology in gonorrhea patients (at diagnosis and 3 months after therapy)
• Metabolic: Electrolytes in patients with low potassium reserves (periodically); electrolyte status in patients with impaired cardiac function (during prolonged therapy)
• Renal: Renal system function (periodically during prolonged therapy)

Patient advice:

• Avoid missing doses and complete the entire course of therapy.

Further information

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.

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