Gram negative infections (when less toxic antibiotics are unsuitable).
By intramuscular injection, and in acute infections adults may be given 15 mg/kg daily, to a maximum of 1.5 g daily, in 2 to 4 divided doses. The same doses may be given by intravenous infusion of a 0.25 to 0.5% solution over 30 to 60 minutes.
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Irreversibly binds to 30s sub-unit of bacterial ribosomes; blocks recognition step in protein synthesis and causes growth inhibition.
Avoid use with potent diuretics, nephrotoxic and neurotoxic drugs, impaired renal functions, myasthenia gravis.
Pregnancy and lactation, myasthenia gravis
Vestibular and auditory damage, nephrotoxicity; rarely, hypomagnesaemia on prolonged therapy, antibiotic-associated colitis, stomatitis; also reported, nausea, vomiting, rash, blood disorders.