Indications: aerobic and anaerobic Gram-positive and Gram-negative infections; surgical prophylaxis; hospital- acquired septicaemia.

Caution sensitivity to beta-lactam antibacterial (avoid if history of immediate hypersensitivity reaction), renal impairment; CNS disorders (e.g. epilepsy); pregnancy, breast-feeding.

Side Effects: nausea, vomiting, diarrhoea (antibiotic- associated colitis), taste disturbances, tooth or tongue discoloration, hearing loss; blood disorders, positive Coombs' test; allergic reactions (with rash, pruritus, urticaria, Stevens-Johnson syndrome, fever, anaphylactic reactions, rarely toxic epidermal necrolysis, exfoliative dermatitis); myoclonic activity, convulsions, confusion and mental disturbances; slight increases in liver enzymes and bilirubin, rarely hepatitis; increases in serum creatinine and blood urea; red coloration of urine in children; local reactions: erythema, pain and induration, and thrombophlebitis.

Dose: By deep intramuscular injection, mild to moderate infections, in terms of imipenem, 500–750 mg every 12 hours.

By intravenous infusion, in terms of imipenem, 1–2 g daily (in 3–4 divided doses); less sensitive organisms, up to 50 mg/kg daily (max. 4 g daily) in 3–4 divided doses; CHILD 3 months and older, 60 mg/kg (up to max. of 2 g) daily in 4 divided doses; over 40 kg, adult dose.

Surgical prophylaxis, by intravenous infusion, 1 g at induction repeated after 3 hours, supplemented in high risk (e.g. colorectal) surgery by doses of 500 mg 8 and 16 hours after induction.