Sandbox g15

Antibiotic Agent	Antimicrobial Spectrum	Dosing Information	Notable Adverse Reaction
Amikacin	Escherichia coli Klebsiella Proteus Enterobacter Serratia Pseudomonas	Neonates (postnatal age ≤ 7 days): 7.5 mg/kg q 12-18 hr IV or IM (≤ 2,000 g); 10 mg/kg q 12 hr IV or IM (> 2,000 g) Neonates (postnatal age > 7 days): 7.5 mg/kg q 8-12 hr IV or IM (≤ 2,000 g); 10 mg/kg q 8 hr IV or IM (> 2,000 g) Children: 15-25 mg/kg/24 hr divided q 8-12 hr IV or IM Adults: 15 mg/kg 24 hr divided q 8-12 hr IV or IM	Ototoxicity Nephrotoxicity
Amoxicillin	Gram-positive pathogens except Staphylococcus Salmonella Shigella Neisseria E. coli Proteus mirabilis	Children: 20-50 mg/kg/24 hr divided q 8-12 hr PO. Higher dose of 80-90 mg/kg 24 hr PO for otitis media Adults: 250-500 mg q 8-12 hr PO	Rash Diarrhea Cramping
Amoxicillin-Clavulanate	S. aureus, methicillin-susceptible Streptococcus Haemophilus influenzae Moraxella catarrhalis E. coli Klebsiella Bacteroides fragilis	Neonates: 30 mg/kg/24 hr divided q 12 hr PO. Children: 20-45 mg/kg 24 hr divided q 8-12 hr PO. Higher dose 80-90 mg/kg/24 hr PO for otitis media.	Diarrhea Rash
Ampicillin	Gram-positive pathogens except Staphylococcus Salmonella Shigella Neisseria E. coli Proteus mirabilis	Neonates (postnatal age ≤ 7 days): 50 mg/kg/24 hr IV or IM q 12 hr (≤ 2,000 g); 75 mg/kg/24 hr divided q 8 hr IV or IM (> 2,000 g) Neonates (postnatal age > 7 days): 50 mg/kg/24 hr IV or IM q 12 hr (< 1,200 g); 75 mg/kg/24 hr divided q 8 hr IV or IM (1,200–2,000 g); 100 mg/kg/24 hr divided q 6 hr IV or IM (> 2,000 g) Children: 100-200 mg/kg/24 hr divided q 6 hr IV or IM Adults: 250-500 mg q 4-8 hr IV or IM	Diarrhea
Ampicillin-Sulbactam	S. aureus H. influenzae M. catarrhalis E. coli Klebsiella B. fragilis	Children: 100-200 mg/kg/24 hr divided q 4-8 hr IV or IM Adults: 1-2 g q 6-8 hr IV or IM (max daily dose: 8 g)	Diarrhea Rash
Azithromycin	S. aureus Streptococcus H. influenzae Mycoplasma Legionella Chlamydia trachomatis	Children: 10 mg/kg PO on day 1 (max dose: 500 mg) followed by 5 mg/kg PO q 24 hr for 4 days. Adults: 500 mg PO day 1 followed by 250 mg for 4 days.	Gastrointestinal distress
Aztreonam	Gram-negative aerobic bacteria Enterobacteriaceae Pseudomonas aeruginosa	Neonates (postnatal age ≤ 7 days): 60 mg/kg/24 hr divided q 12 hr IV or IM (≤ 2,000 g); 90 mg/kg/24 hr divided q 8 hr IV or IM (> 2,000 g) Neonates (postnatal age > 7 days): 60 mg/kg/24 hr divided q 12 hr IV or IM (< 1,200 g); 90 mg/kg/24 hr divided q 8 hr IV or IM (1,200–2,000 g); 120 mg/kg/24 hr divided q 6-8 hr IV or IM (> 2,000 g) Children: 90-120 mg/kg/24 hr divided q 6-8 hr IV or IM Adults: 1-2 g IV or IM q 8-12 hr (max dose: 8 g/24 hr)	Rash Thrombophlebitis Eosinophilia
Carbenicillin	Enterobacter Proteus Pseudomonas	Neonates (postnatal age ≤ 7 days): 225 mg/kg/24 hr divided q 8 hr IV or IM (≤ 2,000 g); 300 mg/kg/24 hr divided q 6 hr IV or IM (> 2,000 g) Neonates (postnatal age > 7 days): 300-400 mg/kg/24 hr divided q 6 hr IV or IM Children: 400-600 mg/kg/24 hr divided q 4-6 hr IV or IM	Rash Liver transaminases elevation
Cefaclor	S. aureus S. pneumoniae H. influenzae E. coli Klebsiella Proteus	Children: 20-40 mg/kg/24 hr divided q 8-12 hr PO (max dose: 2 g) Adults: 250-500 mg q 6-8 hr PO	Rash Eosinophilia Serum sickness
Cefadroxil	S. aureus Streptococcus E. coli Klebsiella Proteus	Children: 30 mg/kg/24 hr divided q 12 hr PO (max dose: 2 g) Adults: 250-500 mg q 8-12 hr PO	Rash Eosinophilia
Cefazolin	S. aureus Streptococcus E. coli Klebsiella Proteus	Neonates (postnatal age ≤ 7 days): 40 mg/kg/24 hr divided q 12 hr IV or IM Neonates (postnatal age > 7 days): 40-60 mg/kg/24 hr divided q 8 hr IV or IM Children: 50-100 mg/kg/24 hr divided q 8 hr IV or IM Adults: 0.5-2g q 8 hr IV or IM (max dose: 12 g/24 hr)	Rash Eosinophilia
Cefdinir	Extended-spectrum cephalosporin	Children: 14 mg/kg/24 hr in 1 or 2 doses PO (max dose: 600 mg/24 hr) Adults: 600 mg q 24 hr PO	Diarrhea
Cefepime	Gram-positive bacteria Gram-negative bacteria including P. aeruginosa	Children: 100-150 mg/kg/24 hr q 8-12 hr IV or IM Adults: 2-4 g/24 hr q 12 hr IV or IM	Diarrhea Nausea Vaginal candidiasis Rash Eosinophilia
Cefixime	Streptococci H. influenzae M. catarrhalis Neisseria gonorrhoeae Serratia marcescens P. vulgaris	Children: 8 mg/kg/24 hr divided q 12-24 hr PO Adults: 400 mg/24 hr divided q 12-24 hr PO	Rash Eosinophilia
Cefoperazone	Gram-positive pathogens Gram-negative pathogens	Neonates: 100 mg/kg/24 hr divided q 12 hr IV or IM Children: 100-150 mg/kg/24 hr divided q 8-12 hr IV or IM Adults: 2-4 g/24 hr divided q 8-12 hr IV or IM (max dose: 12 g/24 hr)	Hypoprothrombinemia Disulfiram-life reaction
Cefotaxime	Gram-positive pathogens Gram-negative pathogens	Neonates (postnatal age ≤ 7 days): 100 mg/kg/24 hr divided q 12 hr IV or IM Neonates (postnatal age > 7 days): 100 mg/kg/24 hr divided q 12 hr IV or IM (< 1,200 g); 150 mg/kg/24 hr divided q 8 hr IV or IM (> 1,200 g) Children: 150 mg/kg/24 hr divided q 6-8 hr IV or IM Adults: 1-2 g q 8-12 hr IV or IM (max dose: 12 g/24 hr)	Rash Eosinophilia
Cefotetan	S. aureus Streptococcus H. influenzae E. coli Klebsiella Proteus Bacteroides	Children: 40-80 mg/kg/24 hr divided IV or IM q 12 hr Adults: 2-4 g/24 hr divided q 12 hr IV or IM (max dose: 6 g/24 hr)	Rash Eosinophilia Hypoprothrombinemia Disulfiram-life reaction
Cefoxitin	S. aureus Streptococcus H. influenzae E. coli Klebsiella Proteus Bacteroides	Neonates: 70-100 mg/kg/24 hr divided q 8-12 hr IV or IM Children: 80-160 mg/kg/24 hr divided q 6-8 hr IV or IM Adults: 1-2 g q 6-8 hr IV or IM (max dose: 12 g/24 hr)	Rash Eosinophilia
Cefpodoxime	S. aureus Streptococcus H. influenzae M. catarrhalis N. gonorrhoeae E. coli Klebsiella Proteus	Children: 10 mg/kg/24 hr divided q 12 hr PO Adults: 200-800 mg/24 hr divided q 12 hr PO (max dose: 800 mg/24 hr)	Rash Eosinophilia
Cefprozil	S. aureus Streptococcus H. influenzae E. coli M. catarrhalis Klebsiella Proteus	Children: 30 mg/kg/24 hr divided q 8-12 hr PO Adults: 500-1,000 mg/24 hr divided q 12 hr PO (max dose: 1.5 g/24 hr)	Rash Eosinophilia
Ceftazidime	Gram-positive pathogens Gram-negative pathogens including P. aeruginosa	Neonates (postnatal age ≤ 7 days): 100 mg/kg/24 hr divided q 12 hr IV or IM Neonates (postnatal age > 7 days): 100 mg/kg/24 hr divided q 12 hr IV or IM (< 1,200 g); 150 mg/kg/24 hr divided q 8 hr IV or IM (> 1,200 g) Children: 150 mg/kg/24 hr divided q 8 hr IV or IM Adults: 1-2 g q 8-12 hr IV or IM (max dose: 8-12 g/24 hr)	Rash Eosinophilia
Ceftiaoxime	Gram-positive pathogens Gram-negative pathogens	Children: 150 mg/kg/24 hr divided q 6-8 hr IV or IM Adults: 1-2 g q 6-8 hr IV or IM (max dose: 12 g/24 hr)	Rash Eosinophilia
Ceftriaxone	Gram-positive pathogens Gram-negative pathogens	Neonates: 50-75 mg/kg q 24 hr IV or IM Children: 50-75 mg/kg q 24 hr IV or IM Adults: 1-2 g q 24 hr IV or IM (max dose: 4 g/24 hr)	Rash Eosinophilia
Cefuroxime	S. aureus Streptococcus H. influenzae E. coli M. catarrhalis Klebsiella Proteus	Neonates: 40-100 mg/kg/24 hr divided q 12 hr IV or IM Children: 200-240 mg/kg/24 hr divided q 8 hr IV or IM; 20-30 mg/kg/24 hr divided q 8 hr PO Adults: 750-1,500 mg q 8 hr IV or IM (max dose: 6 g/24 hr)	Rash Eosinophilia
Cephalexin	S. aureus Streptococcus E. coli Klebsiella Proteus	Children: 25-100 mg/kg/24 hr divided q 6-8 hr PO Adults: 250-500 mg q 6 hr PO (max dose: 4 g/24 hr)	Rash Eosinophilia
Cephradine	S. aureus Streptococcus E. coli Klebsiella Proteus	Children: 50-100 mg/kg/24 hr divided q 6-12 hr PO Adults: 250-500 mg q 6-12 hr PO (max dose: 4 g/24 hr)	Rash Eosinophilia
Chloramphenicol	Gram-positive pathogens Salmonella Enterococcus faecium Bacteroides Mycoplasma Chlamydia Rickettsia	Neonates: loading dose of 20 mg/kg followed by Neonates (postnatal age ≤ 7 days): 25 mg/kg/24 hr q 24 hr IV Neonates (postnatal age > 7 days): 25 mg/kg/24 hr q 24 hr IV (< 2,000 g); 50 mg/kg/24 hr divided q 12 hr IV (> 2,000 g) Children: 50-75 mg/kg/24 hr divided q 6-8 hr IV or PO Adults: 50 mg/kg/24 hr divided q 6 hr IV or PO (max dose: 4 g/24 hr)	Gray-baby syndrome Bone marrow suppression Aplastic anemia
Ciprofloxacin	P. aeruginosa Serratia Enterobacter Shigella Salmonella Campylobacter N. gonorrhoeae H. influenzae M. catarrhalis	Neonates: 10 mg/kg q 12 hr PO or IV Children: 15-30 mg/kg/24 hr divided q 12 hr PO or IV Adults: 250-750 mg q 12 hr; 200-400 mg IV q 12 hr PO (max dose: 1.5 g/24 hr)	Tendonitis Dizziness Confusion Crystalluria Photosensitivity
Clarithromycin	S. aureus Streptococcus H. influenzae Legionella Mycoplasma C. trachomatis	Children: 15 mg/kg/24 hr divided q 12 hr PO Adults: 250-500 mg q 12 hr PO (max dose: 1 g/24 hr)	Gastrointestinal distress Dyspepsia Nausea Cramping
Clindamycin	Gram-positive aerobic pathogens Anaerobic cocci except Enterococcus	Neonates (postnatal age ≤ 7 days): 10 mg/kg/24 hr divided q 12 hr IV or IM (≤ 2,000 g); 15 mg/kg/24 hr divided q 8 hr IV or IM (> 2,000 g) Neonates (postnatal age > 7 days): 10 mg/kg/24 hr IV or IM divided q 12 hr (≤ 1,200 g); 15 mg/kg/24 hr divided q 8 hr IV or IM (1,200–2,000 g); 20 mg/kg/24 hr divided q 8 hr IV or IM (> 2,000 g) Children: 10-40 mg/kg/24 hr divided q 6-8 hr IV, IM, or PO Adults: 150-600 mg q 6-8 hr IV, IM, or PO (max dose: 5 g/24 hr IV or IM or 2 g/24 hr PO)	Diarrhea Nausea Pseudomembranous colitis Rash
Cloxacillin	S. aureus and other gram-positive cocci except Enterococcus and coagulase-negative staphylococci	Children: 50-100 mg/kg/24 hr divided q 6 hr PO Adults: 250-500 mg q 6 hr PO (max dose: 4 g/24 hr)	Rash Eosinophilia
Trimethoprim-Sulfamethoxazole	Shigella Legionella Nocardia Chlamydia Pneumocystis jirovecii	Children: 6-20 mg TMP/kg/24 hr or IV divided q 12 hr PO Adults: 160 mg TMP q 12 hr PO	Rash Erythema multiforme Stevens-Johnson syndrome Nausea Leukopenia
Demeclocycline	Gram-positive cocci except Enterococcus Gram-negative bacilli Anaerobes Borrelia burgdorferi Mycoplasma Chlamydia	Children: 8-12 mg/kg/24 hr divided q 6-12 hr PO Adults: 150 mg PO q 6-8 hr	Teeth staining Photosensitivity Diabetes insipidus Nausea Vomiting Diarrhea
Dicloxacillin	S. aureus and other gram-positive cocci except Enterococcus and coagulase-negative staphylococci	Children: 12.5-100 mg/kg/24 hr divided q 6 hr PO Adults: 125-500 mg q 6 hr PO	Rash Eosinophilia
Doripenem	Gram-positive cocci Gram-negative bacilli including P. aeruginosa Anaerobes	Adults: 500 mg q 8 hr IV	Rash Eosinophilia
Doxycycline	Gram-positive cocci except Enterococcus Gram-negative bacilli Anaerobes B. burgdorferi Mycoplasma Chlamydia	Children: 2-5 mg/kg/24 hr divided q 12-24 hr PO or IV (max dose: 200 mg/24 hr) Adults: 100-200 mg/24 hr divided q 12-24 hr PO or IV	Teeth staining Photosensitivity Nausea Vomiting Diarrhea
Erythromycin	Gram-positive organisms Corynebacterium diphtheriae Mycoplasma pneumoniae	Neonates (postnatal age ≤ 7 days): 20 mg/kg/24 hr divided q 12 hr PO Neonates (postnatal age > 7 days): 20 mg/kg/24 hr divided q 12 hr PO (< 1,200 g); 30 mg/kg/24 hr divided q 8 hr PO (> 1,200 g) Children: Usual max dose 2 g/24 hr. Base: 30-50 mg/kg/24 hr divided q 6-8 hr PO. Estolate: 30-50 mg/kg/24 hr divided q 8-12 hr PO. Stearate: 20-40 mg/kg/24 hr divided q 6 hr PO. Lactobionate: 20-40 mg/kg/24 hr divided q 6-8 hr IV. Gluceptate: 20-50 mg/kg/24 hr divided q 6 hr IV; usual max dose 4 g/24 hr IV Adults: Base: 333 mg PO q 8 hr; estolate/stearate/base: 250-500 mg q 6 hr PO	Cramping Nausea Vomiting Diarrhea Hypertrophic pyloric stenosis
Gentamicin	E. coli Klebsiella Proteus Enterobacter Serratia Pseudomonas	Neonates (postnatal age ≤ 7 days): 2.5 mg/kg q 12-18 hr IV or IM (< 2,000 g); 2.5 mg/kg q 12 hr IV or IM (> 2,000 g) Neonates (postnatal age > 7 days): 2.5 mg/kg q 8-12 hr IV or IM (< 2,000 g); 32.5 mg/kg q 8 hr IV or IM (> 2,000 g) Children: 2.5 mg/kg/24 hr divided q 8-12 hr IV or IM; 5-7.5 mg/kg/24 hr IV once daily Adults: 3-6 mg/kg/24 hr divided q 8 hr IV or IM	Ototoxicity Nephrotoxicity
Imipenem-Cilastatin	Gram-positive cocci Gram-negative bacilli including P. aeruginosa Anaerobes	Neonates (postnatal age ≤ 7 days): 20 mg/kg q 18-24 hr IV or IM (< 1,200 g); 40 mg/kg divided q 12 hr IV or IM (> 1,200 g) Neonates (postnatal age > 7 days): 40 mg/kg q 12 hr IV or IM (< 2,000 g); 60 mg/kg q 8 hr IV or IM (> 2,000 g) Children: 60-100 mg/kg/24 hr divided q 6-8 hr IV or IM Adults: 2-4 g/24 hr divided q 6-8 hr IV or IM (max dose: 4 g/24 hr)	Rash Eosinophilia Nausea Seizures
Linezolid	Staphylococcus Streptococcus E. faecium Enterococcus faecalis	Children: 10 mg/kg q 12 hr IV or PO Adults: Pneumonia: 600 mg q 12 hr IV or PO	Bone marrow suppression Pseudomembranous colitis Nausea Diarrhea Headache
Loracarbef	S. aureus Streptococcus H. influenzae M. catarrhalis E. coli Klebsiella Proteus	Children: 30 mg/kg/24 hr divided q 12 hr PO (max dose: 2 g) Adults: 200-400 mg q 12 hr PO (max dose: 800 mg/24 hr)	Rash Eosinophilia
Meropenem	Gram-positive cocci Gram-negative bacilli including P. aeruginosa Anaerobes	Children: 60 mg/kg/24 hr divided q 8 hr IV Adults: 1.5-3 g q 8 hr IV	Rash Eosinophilia
Metronidazole	Anaerobes	Neonates (postnatal age ≤ 7 days): 7.5 mg/kg 48 hr PO or IV (< 1,200 g); 7.5 mg/kg/24 hr q 24 hr PO or IV (1,200–2,000 g); 15 mg/kg/24 hr divided q 12 hr PO or IV (> 2,000 g) Neonates (postnatal age > 7 days): 5 mg/kg/24 hr divided q 12 hr PO or IV (< 2,000 g); 30 mg/kg/24 hr divided q 12 hr PO or IV (> 2,000 g) Children: 30 mg/kg/24 hr divided q 6-8 hr PO or IV Adults: 30 mg/kg/24 hr divided q 6 hr PO or IV (max dose: 4 g/24 hr)	Dizziness Seizures Metallic taste Nausea Hypoprothrombinemia Disulfiram-like reaction
Mezlocillin	E. coli Enterobacter Serratia Bacteroides	Neonates (postnatal age ≤ 7 days): 150 mg/kg/24 hr divided q 12 hr IV Neonates (postnatal age > 7 days): 225 mg/kg divided q 8 hr IV Children: 200-300 mg/kg/24 hr divided q 4-6 hr IV Adults: 2-4 g/dose q 4-6 hr IV (max dose: 12 g/24 hr)	Rash Eosinophilia Liver transaminases elevation
Mupirocin	Staphylococcus Streptococcus	Topical application to the skin 2-4 times per day	Itching
Nafcillin	S. aureus and other gram-positive cocci except Enterococcus and coagulase-negative staphylococci	Neonates (postnatal age ≤ 7 days): 50 mg/kg/24 hr divided q 12 hr IV or IM (< 2,000 g); 75 mg/kg/24 hr divided q 8 hr IV or IM (> 2,000 g) Neonates (postnatal age > 7 days): 75 mg/kg/q 8 hr IV (< 2,000 g); 100 mg/kg divided q 6-8 hr IV (> 2,000 g) Children: 100-200 mg/kg/24 hr divided q 4-6 hr IV Adults: 4-12 g/24 hr divided q 4-6 hr IV (max dose: 12 g/24 hr)	Rash Eosinophilia Phlebitis Neutropenia
Nalidixic acid	E. coli Enterobacter Klebsiella Proteus	Children: 50-55 mg/kg/24 hr divided q 6 hr PO; suppressive therapy 25-33 mg/kg/24 hr divided q 6-8 hr PO Adults: 1 g q 6 hr PO; suppressive therapy: 500 mg q 6 hr PO	Vertigo Dizziness Rash
Neomycin	Gastrointestinal flora	Infants: 50 mg/kg/24 hr divided q 6 hr PO Children: 50-100 mg/kg/24 hr divided q 6-8 hr PO Adults: 500-2,000 mg/dose q 6-8 hr PO	Cramping Diarrhea Rash Ototoxicity Nephrotoxicity
Nitrofurantoin	Gram-positive pathogens Gram-negative pathogens	Children: 5-7 mg/kg/24 hr divided q 6 hr PO (max dose: 400 mg/24 hr); suppressive therapy 1-2.5 mg/kg/24 hr divided q 12-24 hr PO (max dose: 100 mg/24 hr) Adults: 50-100 mg/24 hr divided q 6 hr PO	Vertigo Dizziness Rash Jaundice Interstitial pneumonitis
Ofloxacin	Gram-positive pathogens Gram-negative pathogens Anaerobes Chlamydia trachomatis	Child (< 12 yr): Conjunctivitis: 1-2 drops in affected eye(s) q 2-4 hr for 2 days, then 1-2 drops qid for 5 days. Corneal ulcers: 1-2 drops q 30 min while awake and at 4 hours at night for 2 days, then 1-2 drops hourly for 5 days while awake, then 1-2 drops q 6 hr for 2 days. Otitis externa: 5 drops into affected ear bid for 10 days Child (> 12 yr) and adults: Ophthalmic solution doses same as for younger children. Otitis externa: 10 drops bid for 10–14 days as for younger children	Burning Stinging Eye redness Dizziness
Oxacillin	S. aureus and other gram-positive cocci except Enterococcus and coagulase-negative staphylococci	Neonates (postnatal age ≤ 7 days): 50 mg/kg/24 hr divided q 12 hr IV (< 2,000 g); 75 mg/kg/24 hr IV divided q 8 hr IV (> 2,000 g) Neonates (postnatal age > 7 days):50 mg/kg/24 hr IV divided q 12 hr IV (< 1,200 g); 75 mg/kg/24 hr divided q 8 hr IV (1,200–2,000 g); 100 mg/kg/24 hr IV divided q 6 hr IV (> 2,000 g) Infants: 100-200 mg/kg/24 hr divided q 4-6 hr IV Children: PO 50-100 mg/kg/24 hr divided q 4-6 hr IV Adults: 2-12 g/24 hr divided q 4-6 hr IV (max dose: 12 g/24 hr)	Rash Eosinophilia Neutropenia
Penicillin G Injection. Tablets.	Penicillin active against most gram-positive cocci; S. pneumoniae (resistance is increasing), group A streptococcus, and some gram-negative bacteria (e.g., N. gonorrhoeae, N. meningitidis). Neonates: Postnatal age ≤7 days 1,200-2,000 g: 50,000 units/kg/24 hr divided q 12 hr IV or IM (meningitis: 100,000 units/ kg/24 hr divided q 12 hr IV or IM); 2,000 g: 75,000 units/kg/24 hr divided q 8 hr IV or IM (meningitis: 150,000 units/kg/24 hr divided q 8 hr IV or IM); postnatal age 7 days ≤1,200 g: 50,000 units/kg/24 hr divided q 12 hr IV (meningitis: 100,000 units/kg/24 hr divided q 12 hr IV); 1,200-2,000 g: 75,000 units/kg/24 hr q 8 hr IV (meningitis: 225,000 units/kg/24 hr divided q 8 hr IV); 2,000 g: 100,000 units/kg/24 hr divided q 6 hr IV (meningitis: 200,000 units/kg/24 hr divided q 6 hr IV). Children: 100,000-250,000 units/kg/24 hr divided q 4-6 hr IV or IM (max dose: 400,000 units/kg/24 hr). Adults: 2-24 million units/24 hr divided q 4-6 hr IV or IM.	Cautions: -Lactam safety profile (rash, eosinophilia), allergy, seizures with excessive doses particularly in patients with marked renal disease. Substantial pathogen resistance. Primarily renally eliminated. Drug interaction: Probenecid.
Penicillin G, benzathine Bicillin. Injection.	Long-acting repository form of penicillin effective in the treatment of infections responsive to persistent, low penicillin concentrations (1-4 wk), e.g., group A streptococcus pharyngitis, rheumatic fever prophylaxis. Neonates 1,200 g: 50,000 units/kg IM once. Children: 300,000-1.2 million units/kg q 3-4 wk IM (max dose: 1.2-2.4 million units/dose). Adults: 1.2 million units IM q 3-4 wk.	Cautions: -Lactam safety profile (rash, eosinophilia), allergy. Administer by IM injection only. Substantial pathogen resistance. Primarily renally eliminated. Drug interaction: Probenecid.
Penicillin G, procaine Crysticillin. Injection.	Repository form of penicillin providing low penicillin concentrations for 12 hr. Neonates 1,200 g: 50,000 units/kg/24 hr IM. Children: 25,000-50,000 units/kg/24 hr IM for 10 days (max dose: 4.8 million units/dose). Gonorrhea: 100,000 units/kg (max dose: 4.8 million units/24 hr) IM once with probenecid 25 mg/kg (max dose: 1 g) Adults: 0.6-4.8 million units q 12-24 hr IM.	Cautions: -Lactam safety profile (rash, eosinophilia) allergy. Administer by IM injection only. Substantial pathogen resistance. Primarily renally eliminated. Drug interaction: Probenecid.
Penicillin V Pen VK, V-Cillin K. Tablet: 125, 250, 500 mg. Suspension: 125 mg/5 mL, 250 mg/5 mL.	Preferred oral dosing form of penicillin, active against most gram-positive cocci; S. pneumoniae (resistance is increasing), other Streptococcus, and some gram-negative bacteria (e.g., N. gonorrhoeae, N. meningitidis). Children: 25-50 mg/kg/24 hr divided q 4-8 hr PO. Adults: 125-500 mg q 6-8 hr PO (max dose: 3 g/24 hr).	Cautions: -Lactam safety profile (rash, eosinophilia), allergy, seizures with excessive doses particularly in patients with renal disease. Substantial pathogen resistance. Primarily renally eliminated. Inactivated by penicillinase. Drug interaction: Probenecid.
Piperacillin Pipracil. Injection.	Extended-spectrum penicillin active against E. coli, Enterobacter, Serratia, P. aeruginosa, and Bacteroides. Neonates: Postnatal age ≤7 days 150 mg/kg/24 hr divided q 8-12 hr IV; 7 days; 200 mg/kg divided q 6-8 hr IV. Children: 200-300 mg/kg/24 hr divided q 4-6 hr IV; cystic fibrosis: 350-500 mg/kg/24 hr IV. Adults: 2-4 g/dose q 4-6 hr (max dose: 24 g/24 hr) IV.	Cautions: -Lactam safety profile (rash, eosinophilia); painful given intramuscularly; each gram contains 1.9 mEq sodium. Interferes with platelet aggregation/serum sickness-like reaction with high doses; increases in liver function tests. Renally eliminated. Inactivated by penicillinase. Drug interaction: Probenecid.
Piperacillin-tazobactam Zosyn. Injection.	Extended-spectrum penicillin (piperacillin) combined with a β-lactamase inhibitor (tazobactam) active against S. aureus, H. influenzae, E. coli, Enterobacter, Serratia, Acinetobacter, P. aeruginosa, and Bacteroides. Children: 300-400 mg/kg/24 hr divided q 6-8 hr IV or IM. Adults: 3.375 g q 6-8 hr IV or IM.	Cautions: -Lactam safety profile (rash, eosinophilia); painful given intramuscularly; each gram contains 1.9 mEq sodium. Interferes with platelet aggregation, serum sickness–like reaction with high doses, increases in liver function test results. Renally eliminated. Drug interaction: Probenecid.
Quinupristin/dalfopristin Synercid. IV injection: powder for reconstitution, 10 mL contains 150 mg quinupristin, 350 mg dalfopristin.	Streptogramin antibiotic (quinupristin) active against vancomycin-resistant E. faecium (VRE) and methicillin- resistant S. aureus (MRSA). Not active against E. faecalis. Children and adults: VRE: 7.5 mg/kg q 8 hr IV for VRE; skin infections: 7.5 mg/kg q 12 hr IV.	Adverse events: Pain, edema, or phlebitis at injection site, nausea, diarrhea. Drug interactions: Synercid is a potent inhibitor of CYP 3A4.
Sulfadiazine Tablet: 500 mg.	Sulfonamide antibiotic primarily indicated for the treatment of lower urinary tract infections due to E. coli, P. mirabilis, and Klebsiella. Toxoplasmosis: Neonates: 100 mg/kg/24 hr divided q 12 hr PO with pyrimethamine 1 mg/kg/24 hr PO (with folinic acid). Children: 120-200 mg/kg/24 hr divided q 6 hr PO with pyrimethamine 2 mg/kg/24 hr divided q 12 hr PO ≥3 days then 1 mg/kg/24 hr (max dose: 25 mg/24 hr) with folinic acid. Rheumatic fever prophylaxis: ≤30 kg: 500 mg/24 hr q 24 hr PO; 30 kg: 1 g/24 hr q 24 hr PO.	Cautions: Rash, Stevens-Johnson syndrome, nausea, leukopenia, crystalluria. Renal and hepatic elimination; avoid use with renal disease. Half-life ∼10 hr. Drug interactions: Protein displacement with warfarin, phenytoin, methotrexate.
Sulfamethoxazole Gantanol. Tablet: 500 mg. Suspension: 500 mg/5 mL.	Sulfonamide antibiotic used for the treatment of otitis media, chronic bronchitis, and lower urinary tract infections due to susceptible bacteria. Children: 50-60 mg/kg/24 hr divided q 12 hr PO. Adults: 1 g/dose q 12 hr PO (max dose: 3 g/24 hr).	Cautions: Rash, Stevens-Johnson syndrome, nausea, leukopenia, crystalluria. Renal and hepatic elimination; avoid use with renal disease. Half-life 12 hr. Initial dose often a loading dose (doubled). Drug interactions: Protein displacement with warfarin, phenytoin, methotrexate.
Sulfisoxazole Gantrisin. Tablet: 500 mg. Suspension: 500 mg/5 mL. Ophthalmic solution, ointment.	Sulfonamide antibiotic used for the treatment of otitis media, chronic bronchitis, and lower urinary tract infections due to susceptible bacteria. Children: 120-150 mg/kg/24 hr divided q 4-6 hr PO (max dose: 6 g/24 hr). Adults: 4-8 g/24 hr divided q 4-6 hr PO.	Cautions: Rash, Stevens-Johnson syndrome, nausea, leukopenia, crystalluria. Renal and hepatic elimination; avoid use with renal disease. Half-life ∼7-12 hr. Initial dose often a loading dose (doubled). Drug interactions: Protein displacement with warfarin, phenytoin, methotrexate.
Ticarcillin Ticar. Injection.	Extended-spectrum penicillin active against E. coli, Enterobacter, Serratia, P. aeruginosa, and Bacteroides. Neonates: Postnatal age ≤7 days 2,000 g: 150 mg/kg/24 hr divided q 8-12 hr IV; 7 days 2,000 g: 225 mg/kg/24 hr divided q 8 hr IV; 7 days 1,200 g: 150 mg/kg/24 hr divided q 12 hr IV; 1,200- 2,000 g: 225 mg/kg/24 hr divided q 8 hr IV; 2,000 g: 300 mg/ kg/24 hr divided q 6-8 hr IV. Children: 200-400 mg/kg/24 hr divided q 4-6 hr IV; cystic fibrosis: 400-600 mg/kg/24 hr IV. Adults: 2-4 g/dose q 4-6 hr IV (max dose: 24 g/24 hr).	Cautions: -Lactam safety profile (rash, eosinophilia); painful given intramuscularly; each gram contains 5-6 mEq sodium. Interferes with platelet aggregation; increases in liver function tests. Renally eliminated. Inactivated by penicillinase. Drug interaction: Probenecid.
Ticarcillin-clavulanate Timentin. Injection.	Extended-spectrum penicillin (ticarcillin) combined with a β-lactamase inhibitor (clavulanate) active against S. aureus, H. influenzae, Enterobacter, E. coli, Serratia, P. aeruginosa, Acinetobacter, and Bacteroides. Children: 280-400 mg/kg/24 hr q 4-8 hr IV or IM. Adults: 3.1 g q 4-8 hr IV or IM (max dose: 18-24 g/24 hr).	Cautions: -Lactam safety profile (rash, eosinophilia); painful given intramuscularly; each gram contains 5-6 mEq sodium. Interferes with platelet aggregation; increases in liver function tests. Renally eliminated. Drug interaction: Probenecid.
Tigecycline Tygacil. Injection.	Tetracycline-class antibiotic (glycylcycline) active against Enterobacteriaceae, including ESBL producers; streptococci (including VRE); staphylococci (including MRSA); and anaerobes. Children: unknown. Adults: 100 mg loading dose followed by 50 mg q 12 hr IV.	Cautions: Pregnancy; children under 8 yr of age; photosensitivity; hypersensitivity to tetracyclines; hepatic impairment (~60% hepatic clearance). Drug interaction: Warfarin; mycophenolate mofetil.
Tobramycin Nebcin, Tobrex. Injection. Ophthalmic solution, ointment.	Aminoglycoside antibiotic active against gram-negative bacilli, especially E. coli, Klebsiella, Enterobacter, Serratia, Proteus, and Pseudomonas. Neonates: Postnatal age ≤7 days, 1,200-2,000 g: 2.5 mg/kg q 12-18 hr IV or IM; 2,000 g: 2.5 mg/kg q 12 hr IV or IM; postnatal age 7 days, 1,200-2,000 g: 2.5 mg/kg q 8-12 hr IV or IM; 2,000 g: 2.5 mg/kg q 8 hr IV or IM. Children: 2.5 mg/kg/24 hr divided q 8-12 hr IV or IM. Alternatively may administer 5-7.5 mg/kg/24 hr IV. Preservative-free preparation for intraventricular or intrathecal use: neonate: 1 mg/24 hr; children: 1-2 mg/24 hr; adults: 4-8 mg/24 hr. Adults: 3-6 mg/kg/24 hr divided q 8 hr IV or IM.	Cautions: S. pneumoniae, other Streptococcus, and anaerobes are resistant. May cause ototoxicity and nephrotoxicity. Monitor renal function. Drug eliminated renally. Administered IV over 30-60 min. Drug interactions: May potentiate other ototoxic and nephrotoxic drugs. Target serum concentrations: Peak 6-12 mg/L; trough 2 mg/L.
Trimethoprim Proloprim, Trimpex. Tablet: 100, 200 mg	Folic acid antagonist effective in the prophylaxis and treatment of E. coli, Klebsiella, P. mirabilis, and Enterobacter urinary tract infections; P. carinii pneumonia. Children: For urinary tract infection: 4-6 mg/kg/24 hr divided q 12 hr PO. Children 12 yr and adults: 100-200 mg q 12 hr PO. P. carinii pneumonia (with dapsone): 15-20 mg/kg/24 hr divided q 6 hr for 21 days PO.	Cautions: Megaloblastic anemia, bone marrow suppression, nausea, epigastric distress, rash. Drug interactions: Possible interactions with phenytoin, cyclosporine, rifampin, warfarin.
Vancomycin Vancocin, Luphocin. Injection. Capsule: 125 mg, 250 mg. Suspension.	Glycopeptide antibiotic active against most gram-positive pathogens including Staphylococcus (including MRSA and coagulase-negative staphylococci), S. pneumoniae including penicillin-resistant strains, Enterococcus (resistance is increasing), and C. difficile–associated colitis. Neonates: Postnatal age ≤7 days, 1,200 g: 15 mg/kg/24 hr divided q 24 hr IV; 1,200-2,000 g: 15 mg/kg/24 hr divided q 12-18 hr IV; 2,000 g: 30 mg/kg/24 hr divided q 12 hr IV; postnatal age 7 days, 1,200 g: 15 mg/kg/24 hr divided q 24 hr IV; 1,200-2,000 g: 15 mg/kg/24 hr divided q 8-12 hr IV; 2,000 g: 45 mg/kg/24 hr divided q 8 hr IV. Children: 45-60 mg/kg/24 hr divided q 8-12 hr IV; C. difficile– associated colitis; 40-50 mg/kg/24 hr divided q 6-8 hr PO. 40-50 mg/kg/24 hr divided q 6-8 hr PO.	Cautions: Ototoxicity and nephrotoxicity particularly when co-administered with other ototoxic and nephrotoxic drugs. Infuse IV over 45-60 min. Flushing (red man syndrome) associated with rapid IV infusions, fever, chills, phlebitis (central line is preferred). Renally eliminated. Target serum concentrations: Peak (1 hr after 1 hr infusion) 30-40 mg/L; trough 5-10 mg/L.