Adult Dosing


  • 1g IM/IV daily x 5-14 days
  • First Dose: 1g IM/IV x 1

Specific Indications

  • 1g IM/IV daily for all
  • Intrabdominal infections x 5-14 days
  • Skin Infections = x 7-14 days
  • Pneumonia, community aquired x 10-14 days
  • UTI, complicated = x 10-14 days
  • Gynecologic = x 3-10 days
  • Prophylaxis, colorectal surgery = x 1 dose

Pediatric Dosing

General (3mo-12 years)

  • 30mg/kg/day IM/IV divided BID x 5-14 days
  • First Dose: 15mg/kg IM/IV x 1
  • Max: 1 g/day
  • For duration, see adult specific indication dosing

General (>13 Years)

See adult dosing

Special Populations

  • Pregnancy Rating: B
  • Lactation: Safety unknown
  • Renal Dosing
    • Adult
      • CrCl <30: 500mg daily
      • Hemodyalisis: give 150mg supplement if maintenance dose <6h prior
    • Pediatric
      • CrCl <30: decrease dose 50%
      • Hemodyalisis: give 150mg supplement if maintenance dose <6h prior
  • Hepatic Dosing (Adult & Pediatric)
    • No data


  • Allergy to class/drug
  • Hypersensitivity to amide anesthetics (IM only)


  • Hypersensitivity to Beta-Lactam
  • Seizure history
  • CNS disorder
  • Renal impairment
  • Recent antibiotic associated colitis

Adverse Reactions


  • Hypersensitivity Reaction
  • Anaphylaxis
  • Neurotoxicity
  • Seizures
  • C. diff
  • Superinfection
  • Extravasation with tissue damage
  • Hallucinations
  • Hypertension
  • Tachycardia
  • Drug rash with eosinophilia



  • Half-life: 4h
  • Metabolism: CYP450
  • Excretion: Urine (80%)
  • Mechanism of Action: Bactericidal

Antibiotic Sensitivities[1]

Group Organism Sensitivity
Gram PositiveStrep. Group A, B, C, GS
Strep. PneumoniaeS
Viridans strepS
Strep. anginosus gpS
Enterococcus faecalisR
Enterococcus faeciumR
Staph. EpidermidisS
C. jeikeiumR
L. monocytogenesI
Gram NegativesN. gonorrhoeaeX2
N. meningitidisS
Moraxella catarrhalisS
H. influenzaeS
E. coliS
Klebsiella spS
E. coli/Klebsiella ESBL+S
E coli/Klebsiella KPC+R
Enterobacter sp, AmpC negS
Enterobacter sp, AmpC posS
Serratia spS
Serratia marcescensX1
Salmonella spS
Shigella spS
Proteus mirabilisS
Proteus vulgarisS
Providencia sp.S
Morganella sp.S
Citrobacter freundiiS
Citrobacter diversusS
Citrobacter sp.S
Aeromonas spS
Acinetobacter sp.R
Pseudomonas aeruginosaR
Burkholderia cepaciaR
Stenotrophomonas maltophiliaR
Yersinia enterocoliticaX1
Francisella tularensisX1
Brucella sp.X1
Legionella sp.R
Pasteurella multocidaS
Haemophilus ducreyiX1
Vibrio vulnificusX1
MiscChlamydophila spR
Mycoplasm pneumoniaeR
Rickettsia spX1
Mycobacterium aviumX1
Bacteroides fragilisS
Prevotella melaninogenicaS
Clostridium difficileX2
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

  • Antibiotics


  1. Sanford Guide to Antimicrobial Therapy 2014
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