Other Beta-Lactams

Aztreonam vial

Dosage Adult: IV/IM Gm-ve infections 1-8 g/day in divided doses depending on severity. Max: 8 g/day. UTI 0.5-1 g 8-12 hrly. IM Cystitis; Gonorrhoea 1 g as a single dose.

Overdosage For action to be taken in the event of accidental overdose

Contraindications Hypersensitivity; lactation.

Special Precautions Hypersensitivity to other β-lactams; renal and hepatic impairment; pregnancy.

Adverse Drug Reactions IV: Phloebitis and thrombophloebitis. IM: Pain and swelling at inj site; diarrhoea, nausea, vomiting, altered taste; jaundice, hepatitis, high liver enzymes; long prothrombin time, partial thromboplastin time; rash, urticaria, eosinophilia.

Potentially Fatal: Thrombocytopenia, neutropenia; overgrowth of susceptible organisms; pseudomembranous colitis.

Drug Interactions Concurrent use with oral anticoagulants may increase prothrombin time.

AZENAM

Manufacturer Aristo

Contents aztreonam.

AZENAM vial

1 g x 1's (471.21 INR)

2 g x 1's (882.55 INR)

500 mg x 1's (310 INR)

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Meropenem (MEROZA)

Dosage Adult: IV Susceptible infections 0.5-1 g 8 hrly. Meningitis 2 g 8 hrly. Cystic fibrosis Up to 2 g 8 hrly. Skin infections 500 mg 8 hrly. Diabetic foot; Intra-abdominal infections 1 g 8 hrly.

Overdosage For action to be taken in the event of accidental overdose

Contraindications Hypersensitivity.

Special Precautions History of hypersensitivity to carbapenem, pencillins or other β-lactam antibiotics; infants <3 mth; renal insufficiency; neurological disorders; pregnancy, lactation. Not recommended for use in MRSA.

Adverse Drug Reactions Diarrhoea, nausea, vomiting, abdominal pain; headache; constipation; rash, pruritus, uticaria; apnoea; phlebitis, thrombophlebitis, swelling and pain at inj site; disturbances in LFTs (may cause increases in serum transaminases, alkaline phosphatase, lactic dehydrogenase). Rarely: erythema multiforme; eosinophilia, thrombocytopenia, leucopenia, neutropenia; seizures and CNS effects reported in patients with underlying CNS disorders or renal impairment.

Potentially Fatal: Anaphylaxis; pseudomembranous colitis; Stevens-Johnsons sydrome.

Drug Interactions: Serum levels may be increased by probenecid. May reduce serum valproic acid levels; sub-therapeutic levels may be reached in some patients.

Manufacturer Zydus (Alidac)

Contents meropenem.

MEROZA vial

1 g x 1's (2245 INR)

250 mg x 1's

500 mg x 1's (1194 INR)

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CILANEM (imipenem + cilastatin)

Dosage Adult: IV Susceptible infections As imipenem: 1-2 g/day in divided doses 6-8 hrly. Surgical prophylaxis As imipenem: 1 g on induction of anesth, followed by 1 g 3 hr later. Additional doses of 500 mg may be given at 8 and 16 hr after induction if needed. IM Susceptible infections As imipenem: 500 or 750 mg 12 hrly. Uncomplicated gonorrhoea As imipenem: 500 mg as single dose.

Indication & Dosage Intravenous

Susceptible infections

Adult: In terms of imipenem, 1-2 g daily in divided doses every 6-8 hr, given via IV infusion. Doses 250 or 500 mg are infused over 20-30 minutes, and doses of 750 mg or 1 g over 40-60 minutes.

Child: >40 kg: same as adult dose. >3 mth and <40 kg: 15-25 mg/kg every 6 hr by IV infusion. Up to 90 mg/kg may be given to older children with cystic fibrosis. Neonates and infants <3 mth: 4 wk-3 mth, 25 mg/kg every 6 hr; 1-4 wk, 25 mg/kg every 8 hr; up to 1 wk, 25 mg/kg every 12 hr.

Max Dosage: Adults and children >40 kg: 4 g/day or 50 mg/kg. Children <40 kg: 2 g/day.

Intravenous

Prophylaxis of surgical infections

Adult: In terms of imipenem, 1 g given on induction of anaesthesia, followed by 1 g 3 hr later, with additional doses of 500 mg at 8 and 16 hr after induction if necessary.

Intramuscular

Mild to moderate susceptible infections

Adult: In terms of imipenem, 500 mg or 750 mg every 12 hr.

Intramuscular

Uncomplicated gonorrhea

Adult: In terms of imipenem: A single 500 mg dose may be used. Contraindications Hypersensitivity. Special Precautions