Renal Impairment: The following doses are recommended (based on 500 mg every 6 hours) for patients not on haemodialysis:
- CrCl: >20 ml/min: 500 mg every 6 hours
- CrCl: 5-20 ml/min: 250 mg every 6 hours
- CrCl: <5 ml/min: 250 mg every 50-70 hours.
Recommendations for patients on chronic, intermittent haemodialysis:
- 250 mg at the start of haemodialysis
- 250 mg 6 to 12 hours after the start
- 250 mg 36 to 48 hours after the start
- 250 mg at the start of the next haemodialysis session if more than 30 hours have elapsed since the last dose.
Additional Information for all patients Regardless of patient age or weight, higher doses of up to 1 gm four times daily may be required for infections which are chronic or severe. Treatment should continue for at least 2 to 3 days after symptoms have resolved or bacteria have been eradicated. To reduce the possibility of rheumatic fever or glomerulonephritis resulting from infections with haemolytic streptococci, treatment should be continued for at least 10 days. Throughout treatment of chronic urinary tract infections and for several months thereafter, regular bacteriological and clinical monitoring is required.
Doses below those recommended above should not be prescribed. Paediatric dosages should not exceed those specified for adults, regardless of severity of infection. It may be necessary to continue Lebac Forte therapy for several weeks in persistent infections. Patients may be transferred from intramuscular/intravenous Lebac Forte therapy to oral treatment at the same dosage level.