Indications: infections due to sensitive Gram-positive and Gram-negative bacteria; good activity against Pseudomonas.

Caution sensitivity to beta-lactam antibacterial (avoid if history of immediate hypersensitivity reaction); renal impairment; pregnancy: and breast-feeding: (but appropriate to use); false positive urinary glucose (if tested for reducing substances) and false positive Coombs' test.

Contra-indications: cephalosporin hypersensitivity.

Side Effects: diarrhoea and rarely antibiotic-associated colitis (both more likely with higher doses), nausea and vomiting, abdominal discomfort, headache; allergic reactions including rashes, pruritus, urticaria, serum sickness-like reactions with rashes, fever and arthralgia, and anaphylaxis; Stevens-Johnson syndrome, toxic epidermal necrolysis reported; disturbances in liver enzymes, transient hepatitis and cholestatic jaundice; other side effects: reported include eosinophilia and blood disorders (including thrombocytopenia, leucopenia, agranulocytosis, aplastic anaemia and haemolytic anaemia); reversible interstitial nephritis, hyperactivity, nervousness, sleep disturbances, hallucinations, confusion, hypertonia, and dizziness.

Dose: By deep intramuscular injection or intravenous injection or infusion, 1 g every 8 hours or 2 g every 12 hours; 2 g every 8–12 hours or 3 g every 12 hours in severe infections; single doses over 1 g intravenous route only;

elderly usual max. 3 g daily;

child, up to 2 months 25–60 mg/kg daily in 2 divided doses, over 2 months 30–100 mg/kg daily in 2–3 divided doses; up to 150 mg/kg daily (max. 6 g daily) in 3 divided doses if immunocompromised or meningitis; intravenous route recommended for children.

Urinary-tract and less serious infections, 0.5–1 g every 12 hours.

Pseudomonal lung infection in cystic fibrosis, adult 100– 150 mg/kg daily in 3 divided doses; child up to 150 mg/kg daily (max. 6 g daily) in 3 divided doses; intravenous route recommended for children.

Surgical prophylaxis, prostatic surgery, 1 g at induction of anaesthesia repeated if necessary when catheter removed.