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If renal impairment existseven usual oral or parenteral doses may lead to excessive systemic accumulation of the drug and possible liver toxicityUnder such conditionslower than usual total doses are indicated andif therapy is prolongedserum level determinations of the drug may be advisableThis hazard is of particular importance in the parenteral administration of tetracyclines to pregnant or postpartum patients with pyelonephritisWhen used under these circumstancesthe blood level should not exceed 15 mcg/ml and liver function tests should be made at frequent intervalsOther potentially hepatotoxic drugs should not be prescribed concomitantly.

Oxytetracycline is indicated for treatment of infections caused by the following gram-positive microorganisms when bacteriologic testing indicates appropriate susceptibility to the drug:

Polymyxin B Sulfateone of a group of related antibiotics derived from Bacillus polymyxais rapidly bactericidalThis action is exclusively against gram-negative organismsIt is particularly effective against Pseudomonas aeruginosaBpyocyaneusand Koch-Weeks bacillusfrequently found in local infections of the eye.

To reduce the development of drug-resistant bacteria and maintain effectiveness of Terramycin and other antibacterial drugsTerramycin should be used only to treat or prevent infections that are proven or strongly suspected to be caused by susceptible bacteriaWhen culture and susceptibility information are availablethey should be considered in selecting or modifying antibacterial therapyIn the absence of such datalocal epidemiology and susceptibility patterns may contribute to the empiric selection of therapy.

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