• Type: bacteriostatic antibiotic
  • Dosage Forms: IV, IM, eye drops
  • Common Trade Names:pentamycetin, chloromycetin

Adult Dosing

Infection, General

  • 50-100mg/kg/day IV divided q6h

Bacterial meningitis

  • 4 g/day IV divided q6h
  • Alt: 75-100mg/kg/day IV divided qgh

Pediatric Dosing

Bacterial meningitis

  • 75-100mg/kg/day IV divided q6h; Max 4g/day

Special Populations

  • Pregnancy: Category C (risk not ruled out)
  • Lactation: passes into breast milk and should be avoided if possible
  • Renal Dosing: minimally excreted via kidneys
    • Adult: amount not defined
    • Pediatric: amount not defined
  • Hepatic Dosing: metabolized by the liver, therefore dose must be reduced
    • Adult: amount not defined
    • Pediatric: amount not defined


  • Allergy to class/drug

Adverse Reactions



  • headache
  • nausea, vomiting
  • diarrhea
  • fever
  • rash
  • urticaria
  • peripheral neuropathy
  • blurred vision


  • Half-life: 1.5 - 4.1 hours
  • Metabolism: Liver
  • Excretion: Urine
  • Mechanism of Action: binds to 50S ribosomal subunit inhibiting protein synthesis

Antibiotic Sensitivities[1]

Group Organism Sensitivity
Gram PositiveStrep. Group A, B, C, GS
Strep. PneumoniaeS
Viridans strepX1
Strep. anginosus gpX1
Enterococcus faecalisI
Enterococcus faeciumI
Staph. EpidermidisR
C. jeikeiumR
L. monocytogenesS
Gram NegativesN. gonorrhoeaeS
N. meningitidisS
Moraxella catarrhalisS
H. influenzaeS
E. coliS
Klebsiella spI
E. coli/Klebsiella ESBL+I
E coli/Klebsiella KPC+R
Enterobacter sp, AmpC negR
Enterobacter sp, AmpC posR
Serratia spX1
Serratia marcescensR
Salmonella spS
Shigella spS
Proteus mirabilisX1
Proteus vulgarisI
Providencia sp.X1
Morganella sp.X1
Citrobacter freundiiX1
Citrobacter diversusX1
Citrobacter sp.X1
Aeromonas spX1
Acinetobacter sp.R
Pseudomonas aeruginosaR
Burkholderia cepaciaS
Stenotrophomonas maltophiliaS
Yersinia enterocoliticaS
Francisella tularensisS
Brucella sp.S
Legionella sp.X1
Pasteurella multocidaX1
Haemophilus ducreyiX2
Vibrio vulnificusX2
MiscChlamydophila spS
Mycoplasm pneumoniaeS
Rickettsia spS
Mycobacterium aviumX1
Bacteroides fragilisX2
Prevotella melaninogenicaS
Clostridium difficileI
Clostridium (not difficile)S
Fusobacterium necrophorumS
Peptostreptococcus sp.S


  • S susceptible/sensitive (usually)
  • I intermediate (variably susceptible/resistant)
  • R resistant (or not effective clinically)
  • S+ synergistic with cell wall antibiotics
  • U sensitive for UTI only (non systemic infection)
  • X1 no data
  • X2 active in vitro, but not used clinically
  • X3 active in vitro, but not clinically effective for Group A strep pharyngitis or infections due to E. faecalis
  • X4 active in vitro, but not clinically effective for strep pneumonia

See Also


  1. Sanford Guide to Antimicrobial Therapy 2014
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