Type of Medication: Antibiotic
Indications: Treatment of infection due to Pseudomonas aeruginosa, Burkholderia cepacia complex, H.influenzae, MSSA, S aureus. Anaerobes, Mycobacterium abscessus and Achromobacter xylosoxidans
Side Effects: Nausea, vomiting, diarrhoea (antibiotic associated colitis reported), abdo pain, disturbance in LFTs, headaches, paraesthesia.Hypersensitivity (partial cross allergenicity with other betalactam antibiotics, penicillins and cephalosporins), including rash,pruritis,urticaria, Stevens -Johnson syndrome, fever, anaphylactic reactions, rarley toxic epidermal necrolysis, exfoliative dermatitis. Convulsions, myoclonus, tremor, phlebitis. Increases in creatinine and urea,oliguria, polyuria, taste disturbance, hypotension, palpitations, tachycardia, polyarthralgia, asthenia, red coloration of urine in children.Tooth or tongue discoloration, positive Coombs test, blood disorders.
Route of administration: Adult (Intravenous)
Dose: 500 mg every 6 hours or 1 g every 6 to 8 hours depending on the nature and severity of the infection. Maximum dose: 50 mg/kg/day or 4 g/day, whichever is less.
In renal failure dose reduction may be necessary. Please discuss with a pharmacist.
(Note: Limited data on evidence for dosing in NTM.) Adults (>50 kg): 1 g twice a day (intravenous). Doses of 750 mg three times daily (intravenous) have been used. Adults (<50 kg): 15 mg/kg twice a day (intravenous).
Route of administration: Paediatric (Intravenous)
Dose: Children: 20–40 mg/kg (max 2 g) three times a day (intravenous).
In renal failure dose reduction may be necessary. Please discuss with a pharmacist
(Note: Limited data on evidence for dosing in NTM.) Children: 20–40 mg/kg (max 2 g) three times a day (intravenous).
Examples of some Drug Interactions
Interacting drug: increased toxicity with ganciclovir with possible convulsions
Interacting drug: probenecid can double the plasma level and half life of cilastatin. Only slightly increases plasma level and half life of imipenem.