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To prevent the emergence of resistant microorganisms by the therapy with the drug, it is desirable to check susceptibility and to administer for the shortest period as possible.
Due to the possibility of developing toxic effects in the presence of the continuously maintained serum concentration and prolonged high blood concentrations, the drug should be used with caution in patients with renal failure with the dosage adjustment. In the treatment of patients with the history of renal disorder and in those who are receiving concomitant treatment with aminoglycosides, serial tests of renal function must be performed and the appropriate dose regimens adhered to in order to reduce the risk of nephrotoxicity to a minimum.
In case of repeated oral administration for the treatment of pseudomembranous colitis by Clostridium difficile, if the sign of improvement of symptoms such as diarrhea, abdominal pain and fever does not appear clearly within 7-10 days, treatment should be discontinued.
Prolonged use may result in the overgrowth of non-susceptible microorganisms. If superinfection occurs during therapy, the drug should be discontinued and appropriate measures should be taken.
Serial tests of auditory function is advisable in order to minimize the risk of ototoxicity.
During therapy, serum test, urine analysis and tests of liver function and renal function should be conducted periodically. Patients who will undergo prolonged therapy with the drug or those who are receiving concomitant drugs that may cause neutropenia should have periodic monitoring of the leukocyte count.
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