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Action/Kinetics:
Activity resembles that of neomycin and streptomycin.
Peak therapeutic serum levels: IM, 15-40 mcg/mL.
t
1/2: 2-3 hr.
Toxic serum levels: >35 mcg/mL (peak) and >10 mcg/mL (trough).
Uses:
Parenteral: Initial therapy for infections due to
Escherichia coli, Proteus, Enterobacter aerogenes, Klebsiella pneumoniae, Serratia marcescens and
Acinetobacter. May be combined with a penicillin or cephalosporin before knowing results of susceptibility tests.
Investigational: As part of a multiple-drug regimen for
Mycobacterium avium complex in AIDS clients.
PO: Adjunct to mechanical cleansing of large bowel for suppression of intestinal bacteria; hepatic coma.
Special Concerns:
Use with caution in premature infants and neonates.
Additional Side Effects:
Sprue-like syndrome with steatorrhea, malabsorption, and electrolyte imbalance.
Additional Drug Interactions:
Procainamide
muscle relaxation.
How Supplied:
Capsule: 500 mg;
Injection: 1 g/3 mL, 75 mg/2 mL, 500 mg/2 mL
Dosage
?Capsules
Intestinal bacteria suppression.
1 g every hour for 4 hr;
then, 1 g q 6 hr for 36-72 hr.
Hepatic coma.
8-12 g/day in divided doses.
?IM, IV
Adults and children: 15 mg/kg/day in two to three equal doses. Maximum daily dose should not exceed 1.5 g regardless of route of administration.
For calculating dosage interval (in hr) in clients with impaired renal function, multiply serum creatinine (mg/100 mL) by 9.
?IM
Tuberculosis.
Adults: 15 mg/kg/day. Not recommended for use in children.
?Intraperitoneal
500 mg diluted in 20 mL sterile distilled water.
?Inhalation
250 mg in saline--nebulize b.i.d.-q.i.d.
Irrigation of abscess cavities, pleural space, ventricular cavities.
0.25% solution.
