IV/IM Adult 1-6 g/day in 2 or 3 divided doses.
UTI & less severe infection 500 mg or 1 g every 12 hr.
Most infections 1 g every 8 hr or 2 g every 12 hr.
Prophylaxis in prostatic surgery 1 g at induction of anaesth. Consider a 2nd dose at the time of catheter removal.
Very severe infection particularly in immunocompromised patient including w/ neutropenia 2 g every 8 or 12 hr, or 3 g every 12 hr.
Fibrocystic adult w/ pseudomonal lung infection 100-150 mg/kg/day in 3 divided doses.
Infant & childn >2 mth 30-100 mg/kg/day in 2 or 3 divided doses.
Immunocompromised or fibrocystic childn or childn w/ meningitis Up to 150 mg/kg/day in 3 divided doses. Max: 6 g/day.
Neonate 0-2 mth 25-60 mg/kg daily in 2 divided doses.
Elderly >80 yr Max daily dose: 3 g.
Patient w/ renal impairment Initial loading dose: 1 g. Maintenance doses:
CrCl >50 mL/min Normal dose,
50-31 mL/min 1 g 12 hrly,
30-16 mL/min 1 g 24 hrly,
15-6 mL/min 0.5 g 24 hrly,
<5 mL/min 0.5 g 48 hrly.
Severe infection Increase unit dose by 50% or increase dosing frequency. Serum level should not exceed 40 mg/mL.
Haemodialysis Repeat maintenance dose following each haemodialysis period.
Peritoneal dialysis Can be incorporated into dialysis fluid, usually 125-250 mg for 2 L of dialysis soln.
Patient in renal failure on continuous arteriovenous haemodialysis or high-flux haemofiltration in intensive therapy units 1 g daily either as single dose or in divided doses.
Patient in renal failure on low-flux haemofiltration Follow dosage recommended under renal impairment.
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