Mezlocillin sodium
Mezlocillin sodium (Mezlin)
Mezlocillin sodium
(mez-low-SILL-in)
Pregnancy Category: B Mezlin (Rx)

Classification: Antibiotic, penicillin

See Also: See also Anti-Infectives and Penicillins.

Action/Kinetics: Broad-spectrum (gram-negative and gram-positive organisms, including aerobic and anaerobic strains) antibiotic used parenterally. Therapeutic serum levels: 35-45 mcg/mL. t1/2: IV, 55 min. Excreted mostly unchanged by the kidneys. Penetration to CSF is poor unless meninges are inflamed.

Uses: (1) Lower respiratory tract infections, including pneumonia and lung abscess, due to Haemophilus influenzae, Klebsiella pneumoniae, Proteus mirabilis, Pseudomonas aeruginosa, E. coli, and Bacteroides fragilis. (2) Intra-abdominal infections, including acute cholecystitis, cholangitis, peritonitis, hepatic abscess, and intra-abdominal abscess due to E. coli, P. mirabilis, Klebsiella species (sp.), Pseudomonas sp., Streptococcus faecalis, Bacteroides sp., Peptococcus sp., and Peptostreptococcus sp. (3) UTIs due to E. coli, P. mirabilis, Proteus sp. (indole-positive), Morganella morganii, Klebsiella sp., Enterobacter sp., Serratia sp., Pseudomonas sp., and S. faecalis. (4) Uncomplicated gonorrhea due to Neisseria gonorrhoeae. (5) Gynecologic infections, including endometritis, pelvic cellulitis, and PID due to N. gonorrhoeae, Peptococcus sp., Peptostreptococcus sp., Bacteroides sp., E. coli, P. mirabilis, Klebsiella sp., and Enterobacter sp. (6) Skin and skin structure infections due to S. faecalis, E. coli, P. mirabilis, Proteus sp. (indole-positive), P. vulgaris, Providencia rettgeri, Klebsiella sp., Enterobacter sp., Pseudomonas sp., Peptococcus sp., and Bacteroides sp. Septicemia, including bacteremia, due to E. coli, Klebsiella sp., Enterobacter sp., Pseudomonas sp., Bacteroides sp., and Peptococcus sp.
Streptococcal infections due to Streptococcus sp., including group A beta-hemolytic streptococcus and S. pneumoniae. However, these infections are usually treated with more narrow spectrum penicillins. Use in certain severe infections when the causative organisms are not known; give in conjunction with an aminoglycoside or a cephalosporin. In combination with an aminoglycoside to treat life-threatening P. aeruoginosa infections. Perioperative use to decrease incidence of infection in clients undergoing surgical procedures that are classified as contaiminated or potentially contaminated (e.g., vaginal hysterectomy, colorectal surgery). Caesarean section intraoperative after clamping the umbilical cord and postoperative to reduce postoperative infections.

Additional Side Effects: Bleeding abnormalities. Decreased hemoglobin or hematocrit values.

Laboratory Test Alterations: AST, ALT, serum alkaline phosphatase, serum bilirubin, serum creatinine, and/or BUN. Serum potassium.

How Supplied: Powder for injection: 1 g, 2 g, 3 g, 4 g, 20 g

Dosage
•IV, IM Serious infections.
Adults: 200-300 mg/kg/day in four to six divided doses; usual: 3 g q 4 hr or 4 g q 6 hr. Infants and children, 1 month-12 years: 50 mg/kg q 4 hr given IM or IV over 30 min; infants more than 2 kg and less than 1 week of age or less than 2 kg and less than 1 week of age: 75 mg/kg q 12 hr; infants less than 2 kg and more than 1 week of age: 75 mg/kg q 8 hr; infants more than 2 kg and more than 1 week of age: 75 mg/kg q 6 hr.
Life-threatening infections.
Adults: Up to 350 mg/kg/day, not to exceed 24 g/day. If C_CR is 10 to 30 mL/min, give 3 g q 8 hr; if C_CR is less than 10 mL/min, give 2 g q 8 hr.
Uncomplicated UTIs.
100-125 mg/kg/day (6 to 8 g/day); 1.5-2 g q 6 hr. If there is renal impairment, give 1.5 g q 8 hr.
Complicated UTIs.
150-200 mg/kg/day (12 g/day); 3 g q 6 hr IV. If C_CR is 10 to 30 mL/min, give 1.5 g q 6 hr; if C_CR is less than 10 mL/min, give 1.5 g q 8 hr.
Lower respiratory tract infection, intra-abdominal infection, gynecologic infection, skin and skin structure infections, septicemia.
225-300 mg/kg/day (16 to 18 g/day); 4 g q 6 hr or 3 g q 4 hr IV. If C_CR is 10 to 30 mL/min, give 3 g q 8 hr; if C_CR is less than 10 mL/min, give 2 g q 8 hr. For serious systemic infections in those undergoing hemodialysis for renal failure or peritoneal dialysis: 3-4 g after each dialysis; then q 12 hr.
Gonococcal urethritis.
Adults: Single dose of 1-2 g IV or IM with probenecid, 1 g given at time of dosing or up to 30 min before.
Prophylaxis of postoperative infection.
Adults: 4 g 30-90 min prior to start of surgery; then, 4 g, IV, 6 and 12 hr later.
Prophylaxis of infection in clients undergoing cesarean section.
First dose: 4 g IV when cord is clamped; second and third doses: 4 g IV 4 and 8 hr after the first dose.