Skin and soft tissue infections: Abscess, cellulitis, furunculosis, impetigo.
Gastrointestinal tract infections: Bacillary dysentery, enteritis, peritonitis. Bone and joint infection.
Surgical prophylaxis: It is also used in perioperative prophylactic administration (pre-operatively, intra-operatively and post-operatively). In cesarean section, intra-operative (after clamping the umbilical cord) and post-operative use may reduce the incidence of certain post-operative infections.
Oral: The usual dose is 1-2 gm daily in 2 to 4 divided doses. In severe and prolonged infection, the dose can be increased up to 4 gm daily which should be taken in equally divided doses.
Injection: The usual dose is 2-4 gm daily which should be given intramuscularly or intravenously in 3-4 divided doses.
Special dose in the following infections:
Skin and skin structures and respiratory tract infection: Usual dose is 250 mg every 6 hours or 500 mg every 12 hours.
Lobar pneumonia: 500 mg every 6 hours or 1 gm every 12 hours.
Urinary tract infection: Usual dose is 500 mg every 12 hours.
Gastro-intestinal tract infection: 500 mg three to four times daily.
Oral: The usual total dose is 25 to 50 mg/kg/day given in 2 to 4 equally divided doses.
Injection: 50 to 100 mg/kg/day in 4 equally divided doses. The usual total dose may be increased up to 200-300 mg/kg/day.
Perioperative prophylaxis: Recommended dose is 1-2 gm by intramuscular or intravenous route; subsequent parenteral or oral doses are given as appropriate. Therapy should be continued for a minimum of 48-72 hrs. after the patient becomes asymptomatic or evidence of bacterial eradication has been obtained.
Side effects: Side effects include nausea, vomiting, diarrhoea and abdominal discomfort. Allergic reactions including skin rashes, urticaria, eosinophilia, angioedema and anaphylaxis may occur and elevation of hepatic enzyme values have been noted. Neutropenia has been reported. Super-infection with resistant microorganisms, particularly candida, may follow the treatment. There is also a possibility of development of pseudomembranous colitis. Transient pain may be experienced at the injection site. Thrombophlebitis has been reported following intravenous administrations.