Indications: Lower respiratory-tract, urinary-tract, intra- abdominal and skin infections, and septicaemia, Complicated appendicitis; Infections in neutropenic patients.

Caution history of allergy; false-positive urinary glucose (if tested for reducing substances); renal impairment; pregnancy; breast feeding.

Contra-indications: penicillin hypersensitivity.

Side Effects: hypersensitivity reactions including urticaria, fever, joint pains, rashes, angioedema, anaphylaxis, serum sickness-like reaction; rarely CNS toxicity including convulsions (especially with high doses or in severe renal impairment), interstitial nephritis, haemolytic anaemia, leucopenia, thrombocytopenia, and coagulation disorders; diarrhoea (including antibiotic- associated colitis) nausea, vomiting, diarrhoea; less commonly stomatitis, dyspepsia, constipation, jaundice, hypotension, headache, insomnia, and injection-site reactions; rarely abdominal pain, hepatitis, oedema, fatigue, and eosinophilia; very rarely hypoglycaemia, hypokalaemia, pancytopenia, Stevens-Johnson syndrome, and toxic epidermal necrolysis.

Dose: Lower respiratory-tract, urinary-tract, intra- abdominal and skin infections, and septicaemia:

ADULT and CHILD over 12 years, by intravenous injection over 3–5 minutes or by intravenous infusion, 2.25–4.5 g every 6–8 hours, usually 4.5 g every 8 hours Complicated appendicitis, by intravenous injection over 3–5 minutes or by intravenous infusion, CHILD 2–12 years, 112.5 mg/kg every 8 hours (max. 4.5 g every 8 hours) for 5–14 days;

CHILD under 2 years, not recommended.

Infections in neutropenic patients (in combination with an aminoglycoside), by intravenous injection over 3–5 minutes or by intravenous infusion, ADULT and CHILD over 50 kg, 4.5 g every 6 hours; CHILD less than 50 kg, 90 mg/kg every 6 hours.