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Metronidazole Dosage

Applies to the following strength(s): 500 mg ; 250 mg ; 375 mg ; 750 mg ; 500 mg/100 mL ; benzoate ; 50 mg/mL ; 100 mg/mL

The information at Drugs.com is not a substitute for medical advice. Always consult your doctor or pharmacist.

Usual Adult Dose for Bacterial Infection

IV:
-Loading dose: 15 mg/kg IV once infused over 1 hour
-Maintenance dose: 7.5 mg/kg IV infused over 1 hour every 6 hours
-Maximum dose: 4 g per day
-Duration of therapy: 7 to 10 days

ORAL:
Immediate-release Capsules and Tablets: 7.5 mg/kg orally every 6 hours
-Maximum dose: 4 g per day
-Duration of therapy: 7 to 10 days

Comments:
-The first IV maintenance dose should be started 6 hours after the start of the loading dose.
-IV therapy may be changed to oral when conditions warrant, based upon severity of disease and response of the patient.
-Infections of the bone and joint, lower respiratory tract, and endocardium may require longer treatment.

Uses: For the treatment of serious infections due to susceptible anaerobic bacteria including:
-Gynecologic infections, including endometritis, endomyometritis, tubo-ovarian abscess, and postsurgical vaginal cuff infection, caused by Bacteroides species including the B fragilis group, Clostridium species, Peptococcus species, Peptostreptococcus species, and Fusobacterium species
-Bacterial septicemia caused by Bacteroides species including the B fragilis group and Clostridium species
-Central nervous system (CNS) infections, including meningitis and brain abscess, caused by Bacteroides species including the B fragilis group
-Lower respiratory tract infections, including pneumonia, empyema, and lung abscess, caused by Bacteroides species including the B fragilis group
-Endocarditis caused by Bacteroides species including the B fragilis group

Infectious Diseases Society of America (IDSA) recommendations:
Surgical Site Infections: 500 mg IV every 8 hours in combination with ceftriaxone, ciprofloxacin, or levofloxacin

Uses: For the treatment of infections following operations on the axilla, gastrointestinal tract, perineum, or female genital tract

Usual Adult Dose for Amebiasis

Acute Intestinal Amebiasis (Acute Amebic Dysentery):
-Immediate-release capsules and tablets: 750 mg orally 3 times a day for 5 to 10 days

Amebic Liver Abscess:
-Immediate-release capsules and tablets: 500 to 750 mg orally 3 times a day for 5 to 10 days

Comments: Aspiration or drainage of pus is still needed for amebic liver abscess.

Use: For the treatment of acute intestinal amebiasis (amebic dysentery) and amebic liver abscess

Usual Adult Dose for Pseudomembranous Colitis

IDSA and Society for Healthcare Epidemiology of America (SHEA) recommendations:
Mild to moderate Clostridium difficile infection (CDI) initial episode:
-Immediate release tablets: 500 mg orally 3 times a day for 10 to 14 days

Severe, complicated CDI: 500 mg IV every 8 hours with oral vancomycin

Comments:
-Metronidazole is the drug of choice for initial episode of mild to moderate CDI.
-Vancomycin orally (or rectally if ileus is present) with or without IV metronidazole is the regimen of choice for initial episode of severe, complicated CDI.
-Metronidazole should not be used beyond the first recurrence of CDI or for long-term chronic therapy due to possible neurotoxicity.

Usual Adult Dose for Surgical Prophylaxis

Initial preoperative dose: 15 mg/kg IV infused over 30 to 60 minutes and completed about 1 hour before surgery
Following initial dose: 7.5 mg/kg IV infused over 30 to 60 minutes at 6 and 12 hours after the initial dose

Comments:
-Should be administered, if needed, at 6-hour intervals to maintain effective drug levels
-Prophylactic use should be limited to the day of surgery, following the above guidelines.

Use: For surgical prophylaxis to prevent postoperative infection in contaminated or potentially contaminated colorectal surgery

IDSA, SHEA, American Society of Health-System Pharmacists (ASHP), and Surgical Infection Society (SIS) recommendations:
-IV: 500 mg IV 1 hour before surgery; duration of prophylaxis for all procedures should be less than 24 hours

Colorectal Surgery Prophylaxis:
-Oral: 1 g orally in 3 divided doses over about 10 hours beginning after the mechanical bowl preparation the afternoon or evening before the procedure

Comments:
-May be used in combination with other antibiotics.
-Current guidelines should be consulted for additional information.

Usual Adult Dose for Trichomoniasis

Immediate-release Capsules: 375 mg orally twice a day for 7 consecutive days

Immediate-release Tablets:
-One-day regimen: 2 g orally as a single dose or 1 g twice given in the same day
-Seven-day regimen: 250 mg orally 3 times a day for 7 consecutive days

Comments:
-Single-dose regimens can assure compliance, however, a 7-day course may minimize reinfection by protecting the patient long enough for the sexual contact to be treated.
-The dose regimen should be individualized in females and males; some patients may tolerate 1 regimen more than the other.
-The patient's sexual partner(s) should also be evaluated/treated.
-If repeat courses are required, an interval of 4 to 6 weeks should elapse between courses and the presence of the trichomonad be reconfirmed by appropriate laboratory testing.
-Pregnant patients should not be treated during the first trimester; if alternative therapy was not adequate in a pregnant patient, the 1-day regimen is not recommended (results in higher serum levels which can reach fetal circulation).

Uses:
-Symptomatic trichomoniasis: For the treatment of Trichomonas vaginalis infection in females and males when confirmed by appropriate laboratory procedures (wet smears and/or cultures)
-Asymptomatic trichomoniasis: For the treatment of asymptomatic T vaginalis infection in females when associated with endocervicitis, cervicitis, or cervical erosion
-Treatment of asymptomatic sexual partners: For the simultaneous treatment of asymptomatic sexual partners of treated patients if T vaginalis is present to prevent reinfection of the partner

US CDC recommendations:
Immediate-release Tablets:
-Recommended regimen: 2 g orally as a single dose
-Alternative regimen: 500 mg orally twice a day for 7 days

Trichomoniasis in HIV-infected women:
-Immediate-release tablets: 500 mg orally twice a day for 7 days

Treatment failure with single-dose therapy and reinfection is excluded:
-Immediate-release tablets: 500 mg orally twice a day for 7 days; for patients failing this regimen, 2 g orally once a day for 7 days should be considered

Comments:
-Sexual partner(s) should be treated simultaneously with the same dose; appropriate treatment of sexual partner(s) may increase reported cure rates.
-Women can be treated with 2 g orally as a single dose at any stage of pregnancy.
-Current guidelines should be consulted for additional information.

Usual Adult Dose for Helicobacter pylori Infection

Some experts recommend:
Bismuth quadruple therapy: 250 mg orally 4 times a day
Clarithromycin-based triple therapy: 500 mg orally twice a day
Duration of therapy: 10 to 14 days

Comments:
-Bismuth quadruple therapy is one recommended primary therapy; includes (a proton pump inhibitor [PPI] or histamine-2 receptor antagonist), bismuth, metronidazole, and tetracycline.
-Clarithromycin-based triple therapy is another recommended primary therapy; includes a PPI, clarithromycin, and (amoxicillin or metronidazole).

Usual Adult Dose for Pelvic Inflammatory Disease

US CDC recommendations:
Mild to moderately severe acute pelvic inflammatory disease (PID):
-Immediate-release tablets: 500 mg orally twice a day for 14 days

Comments:
-Recommended regimens for outpatient, oral therapy include ceftriaxone plus doxycycline with or without metronidazole, cefoxitin/probenecid plus doxycycline with or without metronidazole, or other parenteral third-generation cephalosporin plus doxycycline with or without metronidazole.
-Since anaerobic organisms are suspected in the etiology of PID, the addition of metronidazole should be considered; also effectively treats bacterial vaginosis, which is often associated with PID.
-When tuboovarian abscess is present, metronidazole with doxycycline is recommended for continued therapy; provides more effective anaerobic coverage than doxycycline alone.
-Current guidelines should be consulted for additional information.

Usual Adult Dose for Bacterial Vaginosis

Extended-release Tablets: 750 mg orally once a day for 7 consecutive days

Comments: Should be taken under fasting conditions at least 1 hour before or 2 hours after meals.

Use: For the treatment of bacterial vaginosis in non-pregnant women

US CDC recommendations:
-Immediate-release tablets: 500 mg orally twice a day for 7 days

Comments:
-Treatment is recommended for all women with symptoms.
-Current guidelines should be consulted for additional information.

Usual Adult Dose for Intraabdominal Infection

IV:
-Loading dose: 15 mg/kg IV once infused over 1 hour
-Maintenance dose: 7.5 mg/kg IV infused over 1 hour every 6 hours
-Maximum dose: 4 g per day
-Duration of therapy: 7 to 10 days

ORAL:
Immediate-release capsules and tablets: 7.5 mg/kg orally every 6 hours
-Maximum dose: 4 g per day
-Duration of therapy: 7 to 10 days

Comments:
-The first IV maintenance dose should be started 6 hours after the start of the loading dose.
-IV therapy may be changed to oral when conditions warrant, based upon severity of disease and response of the patient.
-Infections of the bone and joint, lower respiratory tract, and endocardium may require longer treatment.

Uses: For the treatment of intraabdominal infections, including intra-abdominal abscess and liver abscess, caused by Bacteroides species including the B fragilis group (B fragilis, B distasonis, B ovatus, B thetaiotaomicron, B vulgatus), Clostridium species, Eubacterium species, Peptococcus species, and Peptostreptococcus species

IDSA and SIS recommendations:
-Immediate-release tablets: 500 mg IV every 8 to 12 hours or 1500 mg IV every 24 hours

Use: For empiric treatment of complicated intraabdominal infection

Usual Adult Dose for Peritonitis

IV:
-Loading dose: 15 mg/kg IV once infused over 1 hour
-Maintenance dose: 7.5 mg/kg IV infused over 1 hour every 6 hours
-Maximum dose: 4 g per day
-Duration of therapy: 7 to 10 days

ORAL:
Immediate-release capsules and tablets: 7.5 mg/kg orally every 6 hours
-Maximum dose: 4 g per day
-Duration of therapy: 7 to 10 days

Comments:
-The first IV maintenance dose should be started 6 hours after the start of the loading dose.
-IV therapy may be changed to oral when conditions warrant, based upon severity of disease and response of the patient.
-Infections of the bone and joint, lower respiratory tract, and endocardium may require longer treatment.

Uses: For the treatment of intraabdominal infections, including intra-abdominal abscess and liver abscess, caused by Bacteroides species including the B fragilis group (B fragilis, B distasonis, B ovatus, B thetaiotaomicron, B vulgatus), Clostridium species, Eubacterium species, Peptococcus species, and Peptostreptococcus species

IDSA and SIS recommendations:
-Immediate-release tablets: 500 mg IV every 8 to 12 hours or 1500 mg IV every 24 hours

Use: For empiric treatment of complicated intraabdominal infection

Usual Adult Dose for Liver Abscess

IV:
-Loading dose: 15 mg/kg IV once infused over 1 hour
-Maintenance dose: 7.5 mg/kg IV infused over 1 hour every 6 hours
-Maximum dose: 4 g per day
-Duration of therapy: 7 to 10 days

ORAL:
Immediate-release capsules and tablets: 7.5 mg/kg orally every 6 hours
-Maximum dose: 4 g per day
-Duration of therapy: 7 to 10 days

Comments:
-The first IV maintenance dose should be started 6 hours after the start of the loading dose.
-IV therapy may be changed to oral when conditions warrant, based upon severity of disease and response of the patient.
-Infections of the bone and joint, lower respiratory tract, and endocardium may require longer treatment.

Uses: For the treatment of intraabdominal infections, including intra-abdominal abscess and liver abscess, caused by Bacteroides species including the B fragilis group (B fragilis, B distasonis, B ovatus, B thetaiotaomicron, B vulgatus), Clostridium species, Eubacterium species, Peptococcus species, and Peptostreptococcus species

IDSA and SIS recommendations:
-Immediate-release tablets: 500 mg IV every 8 to 12 hours or 1500 mg IV every 24 hours

Use: For empiric treatment of complicated intraabdominal infection

Usual Adult Dose for Joint Infection

IV:
-Loading dose: 15 mg/kg IV once infused over 1 hour
-Maintenance dose: 7.5 mg/kg IV infused over 1 hour every 6 hours
-Maximum dose: 4 g per day
-Duration of therapy: 7 to 10 days

ORAL:
Immediate-release capsules and tablets: 7.5 mg/kg orally every 6 hours
-Maximum dose: 4 g per day
-Duration of therapy: 7 to 10 days

Comments:
-The first IV maintenance dose should be started 6 hours after the start of the loading dose.
-IV therapy may be changed to oral when conditions warrant, based upon severity of disease and response of the patient.
-Infections of the bone and joint, lower respiratory tract, and endocardium may require longer treatment.

Uses: As adjunctive therapy for the treatment of bone and joint infections caused by Bacteroides species including B fragilis group

IDSA recommendations:
Native Vertebral Osteomyelitis (NVO): 500 mg orally 3 to 4 times a day

Comments:
-Can be used in the initial course of NVO due to Bacteroides species and other susceptible anaerobes.
-Current guidelines should be consulted for additional information.

Usual Adult Dose for Osteomyelitis

IV:
-Loading dose: 15 mg/kg IV once infused over 1 hour
-Maintenance dose: 7.5 mg/kg IV infused over 1 hour every 6 hours
-Maximum dose: 4 g per day
-Duration of therapy: 7 to 10 days

ORAL:
Immediate-release capsules and tablets: 7.5 mg/kg orally every 6 hours
-Maximum dose: 4 g per day
-Duration of therapy: 7 to 10 days

Comments:
-The first IV maintenance dose should be started 6 hours after the start of the loading dose.
-IV therapy may be changed to oral when conditions warrant, based upon severity of disease and response of the patient.
-Infections of the bone and joint, lower respiratory tract, and endocardium may require longer treatment.

Uses: As adjunctive therapy for the treatment of bone and joint infections caused by Bacteroides species including B fragilis group

IDSA recommendations:
Native Vertebral Osteomyelitis (NVO): 500 mg orally 3 to 4 times a day

Comments:
-Can be used in the initial course of NVO due to Bacteroides species and other susceptible anaerobes.
-Current guidelines should be consulted for additional information.

Usual Adult Dose for Skin or Soft Tissue Infection

IV:
-Loading dose: 15 mg/kg IV once infused over 1 hour
-Maintenance dose: 7.5 mg/kg IV infused over 1 hour every 6 hours
-Maximum dose: 4 g per day
-Duration of therapy: 7 to 10 days

ORAL:
Immediate-release capsules and tablets: 7.5 mg/kg orally every 6 hours
-Maximum dose: 4 g per day
-Duration of therapy: 7 to 10 days

Comments:
-The first IV maintenance dose should be started 6 hours after the start of the loading dose.
-IV therapy may be changed to oral when conditions warrant, based upon severity of disease and response of the patient.
-Infections of the bone and joint, lower respiratory tract, and endocardium may require longer treatment.

Use: Skin and skin structure infections caused by Bacteroides species including the B fragilis group, Clostridium species, Peptococcus species, Peptostreptococcus species, and Fusobacterium species

IDSA recommendations:
Necrotizing infection: 500 mg IV every 6 hours in combination with cefotaxime

Comments:
-Antimicrobial therapy should be continued until further debridement is no longer needed, the patient has improved clinically, and fever has been absent for 48 to 72 hours.
-Current guidelines should be consulted for additional information.

Use: For the treatment of necrotizing infections of the skin, fascia, and muscle

Usual Adult Dose for Giardiasis

Some experts recommend: 250 mg orally 3 times a day for 5 to 7 days

Usual Adult Dose for STD Prophylaxis

US CDC recommendations:
-Immediate-release tablets: 2 g orally once as a single dose in combination with ceftriaxone and azithromycin

Use: For sexually transmitted disease (STD) prophylaxis following sexual assault or abuse

Usual Adult Dose for Nongonococcal Urethritis

US CDC recommendations:
Recurrent or persistent urethritis:
-Immediate-release tablets: 2 g orally once as a single dose

Comments:
-Use should be reserved for recurrent or persistent urethritis in men who have sex with women in areas where T vaginalis is prevalent.
-Sexual partners should be referred for evaluation and appropriate treatment.
-Current guidelines should be consulted for additional information.

Usual Adult Dose for Balantidium coli

US CDC recommendations:
-Immediate-release tablets: 500 to 750 mg orally 3 times a day for 5 days

Usual Adult Dose for Dientamoeba fragilis

US CDC recommendations:
-Immediate-release tablets: 500 to 750 mg orally 3 times a day for 10 days

Usual Adult Dose for Wound Infection

IDSA recommendations:
-Oral: 250 to 500 mg orally 3 times a day
-IV: 500 mg IV every 8 hours

Comments:
-May be used in combination with other antibiotics.
-Current guidelines should be consulted for additional information.

Uses: For the treatment of infections following animal or human bites

Usual Pediatric Dose for Bacterial Infection

American Academy of Pediatrics (AAP) recommendations:
Neonates:
7 days or less:
-Up to 2 kg: 7.5 mg/kg IV every 12 hours
-Greater than 2 kg: 7.5 mg/kg IV every 8 hours
8 to 28 days:
-Up to 2 kg: 7.5 mg/kg IV every 12 hours
-Greater than 2 kg: 7.5 mg/kg IV every 6 hours

Postmenstrual age less than 34 weeks: 7.5 mg/kg IV every 12 hours
Postmenstrual age 34 to 40 weeks: 7.5 mg/kg IV every 8 hours
Postmenstrual age greater than 40 weeks: 7.5 mg/kg IV every 6 hours

Comments:
-All categories (for body weight 2 kg or less and greater than 2 kg; for 7 days or less and 8 to 28 days of age; and all categories of postmenstrual age) should receive a loading dose of 15 mg/kg IV once.
-The longer dosing interval may be used in extremely low birth weight (less than 1 kg) neonates until 2 weeks of life.
-Current guidelines should be consulted for additional information.

1 month or older:
IV: 22.5 to 40 mg/kg/day IV in 3 divided doses
Maximum dose: 1.5 g/day

Oral: 30 to 50 mg/kg/day orally in 3 divided doses
Maximum dose: 2.25 g/day

Usual Pediatric Dose for Amebiasis

Immediate release capsules and tablets: 35 to 50 mg/kg/day orally in 3 divided doses for 10 days

Comments: Aspiration or drainage of pus is still needed for amebic liver abscess.

Use: For the treatment of acute intestinal amebiasis (amebic dysentery) and amebic liver abscess

Usual Pediatric Dose for Pseudomembranous Colitis

AAP recommendations.
1 month or older: 30 mg/kg/day orally in 4 divided doses
Maximum dose: 2 g/day
Duration of therapy: At least 10 days

Comments:
-Antimicrobial therapy for C difficile infection is recommended for symptomatic patients.
-Metronidazole is the drug of choice for initial treatment of mild to moderate diarrhea and for first relapse.
-Vancomycin enema plus IV metronidazole is recommended as initial therapy for patients with severe disease and for patients who do not respond to oral metronidazole.
-Metronidazole should not be used beyond the first recurrence or for chronic therapy due to possible neurotoxicity.
-Current guidelines should be consulted for additional information.

Usual Pediatric Dose for Trichomoniasis

AAP recommendations:
Children less than 45 kg: 45 mg/kg/day orally in 3 divided doses for 7 days
-Maximum dose: 2 g per day

Adolescent vulvovaginitis: 2 g orally once as a single dose

Comments:
-The patient's sexual partner(s) should be treated simultaneously.
-Current guidelines should be consulted for additional information.

Usual Pediatric Dose for Bacterial Vaginosis

AAP recommendations:
Children less than 45 kg: 45 mg/kg/day orally in 3 divided doses for 7 days
-Maximum dose: 2 g per day

Adolescent vulvovaginitis: 500 mg orally twice a day for 7 days

Comments:
-All women with symptoms should be treated.
-Current guidelines should be consulted for additional information.

Usual Pediatric Dose for Giardiasis

Some experts recommend: 15 mg/kg/day orally in 3 divided doses for 5 to 7 days
-Maximum dose: 250 mg/dose

Usual Pediatric Dose for STD Prophylaxis

US CDC recommendations:
-Adolescents: 2 g orally once as a single dose in combination with ceftriaxone and azithromycin

Use: For sexually transmitted disease (STD) prophylaxis following sexual assault or abuse

Usual Pediatric Dose for Balantidium coli

AAP recommendations: 35 to 50 mg/kg/day orally in 3 divided doses for 5 days
-Maximum dose: 750 mg/dose

Usual Pediatric Dose for Dientamoeba fragilis

AAP recommendations: 35 to 50 mg/kg/day orally in 3 divided doses for 10 days
-Maximum dose: 750 mg/dose

Usual Pediatric Dose for Pelvic Inflammatory Disease

US CDC recommendations:
Adolescents:
Mild to moderately severe acute pelvic inflammatory disease (PID):
-Immediate-release tablets: 500 mg orally twice a day for 14 days

Comments:
-Recommended regimens for outpatient, oral therapy include ceftriaxone plus doxycycline with or without metronidazole, cefoxitin/probenecid plus doxycycline with or without metronidazole, or other parenteral third-generation cephalosporin plus doxycycline with or without metronidazole.
-Since anaerobic organisms are suspected in the etiology of PID, the addition of metronidazole should be considered; also effectively treats bacterial vaginosis, which is often associated with PID.
-When tuboovarian abscess is present, metronidazole with doxycycline is recommended for continued therapy; provides more effective anaerobic coverage than doxycycline alone.
-Current guidelines should be consulted for additional information.

Usual Pediatric Dose for Surgical Prophylaxis

IDSA, SHEA, ASHP, and SIS recommendations:
Less than 1 month:
-Less than 1.2 kg: 7.5 mg/kg IV once
-Greater than or equal to 1.2 kg: 15 mg/kg IV once

1 month or older: 15 mg/kg IV once

Comments:
-The maximum pediatric doses should not exceed the usual adult dose of 500 mg.
-Duration of prophylaxis for all procedures should be less than 24 hours.
-Current guidelines should be consulted for additional information.

Colorectal Surgery Prophylaxis:
1 year or older:
-Oral: 15 mg/kg orally in 3 divided doses over about 10 hours beginning after the mechanical bowl preparation the afternoon or evening before the procedure

Renal Dose Adjustments

No adjustment recommended; accumulation of metabolites may occur in end-stage renal disease, warranting monitoring for associated adverse events.

Liver Dose Adjustments

Mild to moderate liver dysfunction: No adjustment recommended.

Severe liver dysfunction (Child-Pugh C):
Immediate-release tablet, capsule, and IV formulations: Dose should be reduced by 50%

Indication specific adjustments for capsule formulation:
-Amebiasis: 375 mg orally every 8 hours for 5 to 10 days
-Trichomoniasis: 375 mg orally every 24 hours for 7 days

Extended-release tablets: Should not be used unless benefits considered to outweigh risks

Precautions

US BOXED WARNING: CARCINOGENICITY:
-This drug has been shown to be carcinogenic in mice and rats.
-Unnecessary use should be avoided.
-Use should be reserved for the conditions for which it is indicated.

Consult WARNINGS section for additional precautions

Dialysis

Hemodialysis: If use of this drug cannot be separated from hemodialysis session, a supplemental dose after the hemodialysis session should be considered, depending on clinical situation of patient.

Other Comments

Administration advice:
-Extended release tablets: Do not split, crush, or chew; should be taken at least 1 hour before or 2 hours after meals (under fasting conditions).
-IV: Should be administered via slow IV drip infusion only, either as continuous or intermittent infusion; cannot be given via direct IV injection (IV bolus) due to low pH (0.5 to 2) of the reconstituted product; it must be further diluted and neutralized for IV infusion.
-Equipment that contains aluminum and would come in contact with IV solution (e.g., needles, cannulae) must not be used.
-IV therapy may be changed to oral metronidazole when conditions warrant, based upon severity of disease and response of patient.

Storage requirements:
-Capsules and Tablets: Protect from light.
-IV: Store below 25C (77F) and protected from light before reconstitution; reconstituted vials are stable for 96 hours when stored below 30C (86F) in room light; diluted and neutralized IV solutions should be used within 24 hours of mixing; neutralized solutions should not be refrigerated (precipitation may occur).

Reconstitution/preparation techniques:
-Order of mixing is important; first step is reconstitution; second step is dilution in IV solution followed by pH neutralization with sodium bicarbonate injection into the dilution.
-The manufacturer's product information should be consulted.

IV compatibility:
-IV admixtures containing this drug and other drugs should be avoided.
-Primary IV fluid should be stopped during infusion.
-The manufacturer product information should be consulted.

General:
-To reduce the development of drug-resistant bacteria and maintain the effectiveness, this drug should be used only to treat or prevent infections that are proven or strongly suspected to be caused by susceptible bacteria.
-When culture and susceptibility information are available, they should be considered in selecting or modifying antibacterial therapy; in absence of such data, local epidemiology and susceptibility patterns may contribute to the empiric selection of therapy.

Monitoring:
-General: Monitor for drug-related side effects in elderly patients and patients with renal and/or liver dysfunction.
-Hematologic: Total and differential leukocyte counts should be made before and after therapy and if re-treatment occurs.

Patient advice:
-Discontinue use of alcoholic beverages or products containing propylene glycol while taking this drug and for at least 3 days after discontinuing use.

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