IM/IV Adult Uncomplicated infection 500 mg to 1 g bd-tds.
Moderately severe & severe infection 500 mg to 1 g tds-qds.
Severe life-threatening infection 1-1.5 g qds.
Renal impairment: CrCl >80 mL/min/1.73 m2 0.5-1 g every 4-8 hr. Total daily dose: 1-4 g,
50-80 mL/min/1.73 m2 0.5-1 g every 6-8 hr. Total daily dose: 1-2 g,
20-50 mL/min/1.73 m2 0.5 g every 12-24 hr. Total daily dose: 0.5-1 g,
<20 mL/min/1.73 m2 0.25-0.5 g every 12-24 hr. Total daily dose: 0.5 g.
Haemodialysis 0.5 g every 80 hr. Administer after each hemodialysis. Total daily dose: 0.5 g.
Surgery: Perioperative use for short minor procedure Initially 1 g 30 min to 1 hr prior to surgery.
Intraoperatively for longer operation (≥2 hr) Administer another dose of 500 mg to 1 g.
Post-op 500 mg to 1 g at 6-8 hr intervals for 24 hr.
Childn Individualized dosage. 25-50 mg/kg daily in 3-4 divided doses. W/drawal vol should be at a conc of 125 mg/mL & 225 mg/mL, respectively.
Infant >1 mth Mild to moderate infection Total daily dose: 25-50 mg/kg in 3-4 divided doses.
Severe infection Total dose: May increase dose to 100 mg/kg.
Renal impairment: CrCl 40-70 mL/min/1.73 m2 60% of standard daily dose in 2 divided doses,
20-40 mL/min/1.73 m2 25% of standard daily dose in 2 divided doses,
5-20 mL/min/1.73 m2 10% of standard daily dose at 24 hr intervals. Apply doses after loading dose administration equiv to standard dose.
Hemodialysis 7 mg/kg at beginning of treatment then 3-4 mg/kg between dialysis sessions (72 hr interval).
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