Dosing: Adult Note: Dose and duration of therapy can vary depending on infecting organism, severity of infection, and clinical response of patient. Treat severe staphylococcal infections for at least 14 days; endocarditis and osteomyelitis require an extended duration of therapy for 4-6 weeks. The intravenous route should be used for severe infections.
Susceptible infections:I.M., I.V.: 250-500 mg every 6 hours (manufacturer recommended maximum adult dose: 6 g/day)
Dosing recommendations of World Health Organization unless otherwise noted:
Arthritis (septic), methicillin-sensitive Staphylococcus aureus (MSSA) (unlabeled dosing): I.M., I.V.: 2 g every 6 hours for 2-3 weeks;
Endocarditis (MSSA) (unlabeled dosing): I.V.:
Native valve: 2 g every 4 hours for 6 weeks; may give with gentamicin for initial 5 days (Choudri, 2000)
Prosthetic valve: 2 g every 4 hours for 6 weeks; give with gentamicin for 2 weeks and rifampin for 6 weeks (Choudri, 2000)
Uncomplicated endocarditis in I.V. drug users: 2 g every 4 hours for 4 weeks and gentamicin for initial 5 days
or 2 g every 4 hours and gentamicin both given for 2 weeks total (Choudri, 2000)
Osteomyelitis (MSSA) (unlabeled dosing): I.M., I.V.: 2 g every 6 hours for 4-6 weeks (preferred) or for a minimum of 14 days, followed by 1 g every 6 hours orally to complete 4-6 weeks of therapy
Pneumonia (MSSA) (unlabeled dosing): I.M., I.V.: 1-2 g every 6 hours for 10-14 days
Dosing: Pediatric Note: Dose and duration of therapy can vary depending on infecting organism, severity of infection, and clinical response of patient. Treat severe staphylococcal infections for at least 14 days; endocarditis and osteomyelitis require an extended duration of therapy for 4-6 weeks. The intravenous route should be used for severe infections.
Susceptible infections: I.M., I.V.:
Children ≤20 kg: 25-50 mg/kg/day in divided doses every 6 hours; up to 200 mg/kg/day has been used in some studies for severe infections (Nunn, 2007; St. John, 1981)
Children >20 kg: Refer to adult dosing.
Dosing recommendations of World Health Organization unless otherwise noted:
Arthritis (septic), methicillin-sensitive Staphylococcus aureus (MSSA) (unlabeled dosing): Children 2 months to 5 years: I.M., I.V.: 25-50 mg/kg (maximum: 2 g) every 4-6 hours given with ceftriaxone until clinical improvement,
followed by oral therapy: 12.5 mg/kg (maximum: 500 mg) every 6 hours; total duration of therapy 2-3 weeks
Children >5 years: I.M., I.V.: 25-50 mg/kg (maximum: 2 g) every 4-6 hours (maximum daily dose: 12 g/day) until clinical improvement,
followed by oral therapy: 25 mg/kg (maximum: 500 mg) every 6 hours; total duration of therapy 2-3 weeks
Endocarditis (MSSA) (unlabeled dosing): I.V.: 50 mg/kg (maximum: 2 g) every 4 hours for 6 weeks; give with gentamicin for initial 7 days
Osteomyelitis (MSSA) (unlabeled dosing):Children 2 months to 5 years: I.M., I.V.: 25-50 mg/kg (maximum: 2 g) every 4-6 hours given with ceftriaxone until clinical improvement, followed by oral therapy: 12.5 mg/kg (maximum: 500 mg) every 6 hours; total duration of therapy 3-4 weeks
Children >5 years: I.M., I.V.: 25-50 mg/kg (maximum: 2 g) every 4-6 hours (maximum daily dose: 12 g/day) until clinical improvement, followed by oral therapy: 25 mg/kg (maximum: 500 mg) every 6 hours; total duration of therapy 3-4 weeks
Pneumonia (MSSA) (unlabeled dosing):Children >5 years: I.M., I.V.: 50 mg/kg (maximum: 2 g) every 6 hours for 10-14 days
Dosing: Geriatric Refer to adult dosing.
Dosing: Renal Impairment No dosage adjustment necessary.