Indications & Dosage

Indications:

It is mainly bacteriostatic drug used in the treatment of serious anaerobic infections, notably due to Bacteroides fragilis. It is also used for Gram-positive infections due to pneumococci, staphylococci, streptococci such as liver abscess, actinomycosis, billary-tract infections, staphylococcal bone and joint infections, the carrier state of diphtheria, endophthalmis, gas gangrene, various gynaecological infections including bacterial vaginosis, endometritis and pelvic inflammatory disease, intra-abdominal infections including emphysema and pneumonia, septicaemia, and skin and soft-tissue infections involving heavy colonization with streptococci or anaerobes such as necrotizing fasciitis.

Dosage and Administration

Adults: Serious infections due to aerobic gram-positive cocci and the more susceptible anaerobes (NOT generally including Bacteroides fragilis, Peptococcus species and Clostridium perfringens): 600-1200 mg/day in 2.3 or 4 equal doses either IM or IV administration.
More severe infections, particularly those due to proven or suspected Bacteroides fragilis, Peptococcus species, or Clostridium species other than Clostridium perfringens:1200-2700 mg/day in 2,3 or 4 equal doses.
For more serious infections, these doses may have to be increased. In life-threatening situations due to either aerobes or anaerobes these doses may be increased. Doses of as much as 4800 mg daily have been given intravenously to adults.
Neonates(Less than 1 month): 15 to 20 mg/kg/day in 3 to 4 equal doses. The lower dosage may be adequate for small prematures.
Pediatric patients 1 month of age to 16 years: 20 to 40 mg/kg/day in 3 or 4 equal doses either IM or IV administration. The higher doses would be used for more severe infections. As an alternative to dosing on a body weight basis, pediatric patients may be dosed on the basis of square meters body surface: 350mg/m2/day for serious infections and 450mg/m2/day for more severe infections.
Parenteral therapy may be changed to oral at the discretion of the physician. In cases of βhemolytic streptococcal infections, treatment should be continued for at least 10 days. Or as prescribed by the physician.

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