• Severe bacterial infections:
    • Adults:
      • IV 12,500-15,000 units/kg/dose BD.
      • Max: 30,000 units/kg/day  OR
      • IM 25,000-30,000 units/kg/day divided every 4-6hrs
    • < 2yrs:
      • IV up to 40,000 units/kg/day divided BD. Max: 45,000 units/kg/day OR
      • IM up to 40,000 units/kg/day divided every 4-6hrs
    • ≥2 yrs:
      • IV 15,000-25,000 units/kg/day divided BD. Max: 25,000 units/kg/day IV, 30,000 units/kg/day OR
      • IM 25,000-30,000 units/kg/day divided every 4-6hrs
  • Bacterial meningitis:
    • Adults:
      • Intrathecal 50,000 units OD
    • <2 yrs:
      • Intrathecal 25,000 units every other day
      • May start 20,000 units OD * 3-4 days and continue every other day for >2 weeks after negative CSF cultures
    • ≥2 yrs:
      • Intrathecal 50,000 units OD *3-4 days, then 50,000 units every other day
  • Hospital-acquired or ventilator-associated pneumonia (Off-label):
    • Adults: IV 25,000-30,000 units/kg/day divided BD *1/52
  • Bacterial ventriculitis (Off-label):
    • Adults: Intracerebroventricularly 50,000 units OD
  • Injection:
    • 500,000 IU
  • IV prep: Dilute 500,000 IU in 300-500mL D5W
  • IM prep: Reconstitute with 2mL sterile water for injection or NS or procaine HCl 1% solution
  • Intrathecal prep: Reconstitute vial with10 mL NS. DO NOT use procaine HCl for IT
  • IV administration: infuse over 60-90 min
  • IM administration: give deep into upper outer quadrant of gluteal muscles

Polypeptide

Bactericidal. It causes leakage of bacterial membrane by binding to phospholipids, increasing cell wall permeability.

  • Albuminuria
  • Urinary casts
  • Azotemia
  • Flushing
  • Dizziness
  • Ataxia
  • Drowsiness
  • Peripheral paresthesia
  • Fever
  • Rash
  • Urticaria
  • Hypersensitivity to drug or ingredient
  • Concurrent use with neurotoxic or nephrotoxic agents
  • Cidofovir

                                   Drug Status

Availability Prescription only
Pregnancy Category B; weigh risk vs benefits
Breastfeeding Can be used
Schedule Not controlled
BRAND NAME STRENGTH FORMULATION PACK SIZE MANUFACTURER DISTRIBUTOR
Poly-Mxb 500,000 IU Injection 1’s Bharat Serum Nairobi Enterprises