General Enquiries: rphcm@crana.org.au
Seek a medical consult for medicine use in pregnancy or breastfeeding
Contact your closest Pregnancy Drug Information Centre for more information on using medicines when a woman is pregnant or breastfeeding
This table must be used with protocols from CARPA STM (8th ed) or WBM (7th ed) – it does not provide all the information needed for appropriate treatment
† = other strengths and forms available. Doses in brackets (mL, tab) only apply to forms and strengths listed. Doses (mL) rounded up to nearest 0.2ml unless this is more than 10% above recommended dose
Aciclovir†
Tab: 200mg, 200mg (disp), 800mg
Susp: (4mg/mL)#
Pregnancy: B3 – safe to use
Breastfeed: safe to use
320mg
(81mL
or 1½ tab
– 200mg)
500mg
(126mL or 2½ tab
– 200mg)
640mg
(161mL or
3½ tab
– 200mg)
# Mix 200mg dispersible tablet in 50mL water to give 4mg/mL solution. Mix well and use straight away.
If weakened immune system – increase dose.15mg/
kg/dose
Doses worked out using amoxicillin component.
Take with food. Caution if liver disease.
62mg
(1.6mL)
76mg
(2mL)
Benzathine benzylpenicillin (Bicillin L-A)
Inj: 1,200,000units/2.3mL
600,000units/1.2mL
syringe
Pregnancy: A – safe to use
Breastfeed: safe to use
600,000units/1.2mL (450mg)
For child 10-19kg
Long lasting low levels of penicillin.
Do not give for pneumonia.
Note: 1,200,000units=900mg
For syphilis dose see STI protocols.
Pregnancy: A – safe to use
Breastfeed: safe to use
Moderate pneumonia
Water-related skin infection
Sore throat
Soft tissue injuries
Cefazolin
Inj#: 500mg, 1g, 2g Pregnancy: B1 – safe to use
Breastfeed: safe to use
# Mix with WFI to give 100mg/mL —
500mg with 4.8mL 1g with 9.5mL 2g with 19mL
Inject over 3 minutes.
Infuse over 30 minutes
Compound fracture
Head injury
Pelvic fracture
Penetrating chest injury
Soft tissue injuries
Severe cellulitis
Stab wounds
Ceftazidime†
Inj#: 1g, 2g Pregnancy: B1– safe to use
Breastfeed: safe to use
# Mix with WFl to give 170mg/mL — 1g with 5mL 2g with 10mL
Inject over 3 minutes
Pregnancy: B1– safe to use
Breastfeed: safe to use
# For IM mix with lidocaine 1% to give 250mg/mL – 500mg + 2mL 1g + 3.5mL Not more than 1g in each buttock
For IV mix with WFI to give 100mg/mL – 500mg + 5mL 1g + 10mL 2g + 40mL
Inject (up to 1g) over 3 minutes
In urgent and critically unwell (sepsis), 2g dose can be injected over 5 minutes
Infuse over at least 30 minutes
Do not mix with Hartman’s solution
Water-related skin infection
Pneumonia
Diarrhoea
Peritonitis
Severe pneumonia
Sepsis
Pregnancy: B3 – not recommended
Breastfeed: safe to use
If kidney disease — reduce dose.
Take 1 hour before or 2 hours after food. Drink plenty of water.
Pregnancy: A – safe to use
Breastfeed: safe to use
# Mix measured dose with glucose 5% or normal saline to give concentration not more than
12mg/mL.
Infuse slowly – not more than 30mg/minute.
Pregnancy: B2 – safe to use
Breastfeed: safe to use
Oral
4 times a day (qid)
OR
Twice a day (bd) with probenecid*
* If giving with probenecid – give same treatment dose but only give twice a day (ie give half usual daily total
dose).
Take on an empty stomach.
Pregnancy: B1 – safe to use
Breastfeed: safe to use
Pregnancy: D – specialist advice
Breastfeed: safe to use
For adult IV push over 3–5 minutes — can be diluted with normal saline to 20mL.
For children need dilution to 10mg/mL or weaker and infuse over 30 minutes.
Administer IM undiluted.
If kidney failure — specialist consult.
No maximum adult dose — continue to calculate dose by weight
If obese — medical consult about adjusted dose.
Adult
5mg/
kg/dose
Pregnancy: B3 – avoid use
Breastfeed: safe to use
Metronidazole†
Susp: 40mg/mL
Tab: 200mg, 400mg
Pregnancy: B2 – safe to use
Breastfeed: safe to use
Bites
Dental infection
Diabetic ulcer
Soft tissue infection
Water-related skin infections
Must not drink alcohol while taking and for 24 hours after.
Take with food.
If pregnant or breastfeeding – give divided doses. Withhold breastfeeding for 12 hours after single high dose (2g)
If severe liver disease – reduce dose.
Do not infuse faster than 5mL/min. Give 500mg over 20 minutes.
Metronidazole
Inj: 5mg/mL
Pregnancy: B2 – safe to use
Breastfeed: safe to use
Phenoxymethyl-penicillin†
Susp: 50mg/mL (250mg/5mL)
Cap: 500mg
Pregnancy: A– safe to use
Breastfeed: safe to use
Pregnancy: B1 – specialist advice
Breastfeed: safe to use
Children don’t like the taste.
Give with food.
Do not chew tablet.
Pregnancy: A – safe to use
Breastfeed: safe to use
Shake well.
Put into another syringe to measure small doses accurately.
Roll syringe between palms to warm before use.
Inject slowly
Pregnancy: B2 – safe to use
Breastfeed: safe to use
Oral
Single dose
Repeat dose in 2 weeks
Take with food. Tablet can be crushed and mixed with jam
Bites
Otitis media
Skin infection
UTI
Soft tissue infection
Nappy rash
Doses worked out using trimethoprim component.
Addition of Folic Acid for prolonged or high dose courses.
Pregnancy: B3 – appears safe in 3rd trimester but aciclovir preferred
Breastfeed: safe to use
Paediatric
15mg/
kg/dose
Medical consult
# Mix with WFI to give 50mg/mL – 500mg+10mL 1g+20mL
Doses 500mg or less can be given over 60 minutes.
Do not infuse doses greater than 500mg at a rate faster than 10mg/minute as red man syndrome can occur
41-50kg
1g (20mL) infuse over 1 hour 40min
51-60kg
1.2g (24mL) infuse over 2 hours
61-70kg
1.4g (28mL) infuse over 2 hours 20min
71-80kg
1.6g (32mL) infuse over 2 hours 40min
81-90kg
1.8g (36mL) infuse over 3 hours
91-100kg
2g (40mL) infuse over 3 hours 20min
101-110kg
2.2g (44mL) infuse over 3 hours 40min
Over 110kg
2.4g (48mL) infuse over 4 hours
Pregnancy categories: ‘Harm’ means to foetus. For more detail see Australian Medicines Handbook or Therapeutic Guidelines
Category A: Have been taken by large numbers of pregnant and fertile women without any known
harm
Category B1: Have been used in a limited number of pregnant and fertile women without any known
harm. Animal studies have not shown harm
Category B2: Women as for B1. Animal studies are less adequate, but no evidence of harm
Category B3: Women as for B1. Animal studies shown some evidence of harm, but not clear if this
is significant for humans
Category C: Have caused or are suspected of causing non–permanent harm
Category D: Have caused or are suspected of causing permanent harm
Category C and D medicines are not always contraindicated for use in fertile women.
The risks and benefits need to be discussed
Category X: Drugs which have such a high risk of causing permanent damage to the foetus that
they should not be used in pregnancy or when there is a possibility of pregnancy
For more information and details on giving antibiotics see AMH, Therapeutic Guidelines, Medicines Book, Australian Injectable Drugs Handbook
General Enquiries: rphcm@crana.org.au