N-CIZ ( POWDER, INJECTION ) ( 1000 mg )

Infections due to sensitive bacteria, especially those due to Pseudomonas spp. and including those resistant to aminoglycosides.

Source : IAP Pediatric Drug Formulary
Neonates < 7 days and > 7 days < 1200gm 100 mg/kg/24 hr in 2 div doses IV/IM, > 7 days > 1200 gm 150mg/ kg/day divided 8th hrly IM/IV. Children 150mg/kg/24 hr divided 8th hrly. Maximum 6gm/day. Single dose > 1gm to be given IV only.

• Dose adjustment in renal failure - In mild impairment give a dose very 12 hours, in moderate impairment (creatinine clearance 10-50ml/minute/1.73m2) give a dose once daily and in severe impairment (creatinine clearance <10ml/ minute/1.73m2) give 50% of dose once daily. Leaves may be monitored if clinically indicated.
• In hemodialysis: the appropriate maintenance dose should be repeated after dialysis.
• In peritoneal dialysis: 125-250mg may be added to 21 of dialysis fluid, and given in addition to the IV dose.

Source : NFI National Formulary of India

Deep intramuscular injection and infusion and intravenous

• Adult- 1g every 8 h or 2g every 12 h.
• Severe infections: 2g every 12 h or 3g every 12 h (1g single dose by intravenous route).
• Immunocompromised or meningitis patients: 150 mg/kg body weight daily in 3 divided doses (max 6g daily) given by i.v route only.
• Elderly- Usual max dose of 3g daily.
• Child- Up to 2 months; 25 to 60g/kg body weight in two divided doses. Over 2months: 30 to 100 mg/kg body weight in 2 to 3 divided doses."

• Cephalosporin hypersensitivity
• Porphyria

• Penicillin sensitivity
• Renal impairment
• Lactation
• False positive urinary glucose (if tested for reducing substances) and false positive Coombs’ test
• Interactions
• Pregnancy
• Fall in prothrombin activity, colitis

• Diarrhoea, nausea, vomiting, abdominal discomfort, headache
• Rarely, antibiotic- associated colitis (particularly with higher doses)
• Allergic reactions including rashes, pruritus, urticaria, serum sickness-like reaction, fever and arthralgia and anaphylaxis
• erythema multiforme, toxic epidermal necrolysis reported; transient hepatitis, cholestatic jaundice; eosinophilia and blood disorders (including thrombocytopenia, leukopenia, agranulocytosis, aplastic anaemia and haemolytic anaemia);
• Reversible interstitial nephritis
• Nervousness, sleep disturbances, confusion, hypertonia and dizziness
• Phlebitis, angioedema, myoclonia, candidiasis, transient elevation of blood urea and serum creatinine

Store in sterile containers sealed so as to exclude micro-organisms protected from moisture at a temperature not exceeding 30⁰C.