Trade Names:Maxipime- Powder for Injection 500 mg- Powder for Injection 1 g- Powder for Injection 2 g
Inhibits mucopeptide synthesis in bacterial cell wall.
C max is 39.1 to 163.9 mcg/mL. AUC is about 70.8 to 284.8 h•mcg/mL.IM (500 mg to 2 g doses)
C max is about 13.9 to 57.5 mcg/mL. AUC is about 60 to 262 h•mcg/mL. T max is about 1.4 to 1.6 h.
Vd is about 18 L (at steady state). About 20% protein bound. Excreted in human milk; crosses the inflamed blood-brain barrier.
Metabolized to N-methylpyrrolidine, which is then converted to the N-oxide.
About 85% is excreted unchanged in the urine; t ½ is 102 to 138 min.
Total body Cl is decreased proportionally with Ccr. Dosage adjustment is recommended.Elderly
Total body Cl is decreased. Adjust dose if Ccr is less than or equal to 60 mL/min.
Treatment of pneumonia and infections of the skin and skin structures and urinary tract caused by susceptible strains of specific microorganisms. Treatment of empiric therapy for febrile neutropenic patients as monotherapy. Treatment for complicated intra-abdominal infections in combination with metronidazole.
Hypersensitivity to cephalosporins, penicillins, or other beta-lactam antibiotics.
IV/IM 0.5 to 1 g every 12 h for 7 to 10 days.Severe Uncomplicated or Complicated UTIsAdults
IV 2 g every 12 h for 10 days.Moderate to Severe PneumoniaAdults
IV 1 to 2 g every 12 h for 10 days.Moderate to Severe Uncomplicated Skin and Skin Structure InfectionsAdults
IV 2 g every 12 h for 10 daysChildren under 40 kg
50 mg/kg/dose every 12 h (every 8 h for febrile neutropenic patients) for 7 to 10 days. Do not exceed the recommended adult dose.Renal Function Impairment (Children)
Data not available; however, changes in dosing regimen similar to those in adults are recommended.
Store unopened vials at room temperature (68° to 77°F). Store reconstituted solutions at room temperature (68° to 77°F) for up to 24 h or refrigerated (36° to 46°F) for up to 7 days. Protect from light.
Increased risk of nephrotoxicity and ototoxicity.
Metronidazole, vancomycin, gentamicin, tobramycin, netilmicin, aminophylline, and ampicillin (greater than 40 mg/mL).
May cause false-positive reaction for glucose in the urine when using Clinitest tablets but not with tests based on enzymatic glucose oxidase reactions (eg, Clinistix ).
Nausea; vomiting; diarrhea; colitis; including pseudomembranous colitis; oral moniliasis.
Rash; pruritus; urticaria.
Hypersensitivity, including Stevens-Johnson syndrome; erythema multiforme; toxic epidermal necrolysis; candidal overgrowth; serum sickness–like reactions (eg, skin rashes, polyarthritis, arthralgia, fever); phlebitis; pain or inflammation at injection site; fever.
MonitorResponse to therapy
Monitor patient's response to therapy. Notify health care provider if infection does not appear to improve or worsens.Side effects
Monitor patient for GI, DERM, and general body side effects, and signs of superinfection. Inform health care provider if noted and significant. Immediately report severe diarrhea, diarrhea containing blood or pus, or severe abdominal cramping.
Category B .
Excreted in breast milk.
Safety and efficacy in children younger than 12 yr of age have not been established.
Reactions range from mild to life-threatening. Administer drug with caution to penicillin-sensitive patients because of possible cross-sensitivity.
Dosage adjustment is necessary in patients with Ccr less than 60 mL/min.
Drug may cause bacterial or fungal overgrowth of nonsusceptible microorganisms.
Consider in patients in whom diarrhea develops.
Seizures, encephalopathy, neuromuscular excitability.
Copyright © 2009 Wolters Kluwer Health.