Sandbox g15
Antibiotic Agent | Antimicrobial Spectrum | Dosing Information | Notable Adverse Reaction |
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Amikacin |
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Amoxicillin |
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Amoxicillin-Clavulanate |
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Ampicillin |
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Ampicillin-Sulbactam |
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Azithromycin |
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Aztreonam |
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Carbenicillin |
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Cefaclor |
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Cefadroxil |
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Cefazolin |
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Cefdinir |
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Cefepime |
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Cefixime |
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Cefoperazone |
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Cefotaxime |
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Cefotetan |
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Cefoxitin |
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Cefpodoxime |
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Cefprozil |
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Ceftazidime |
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Ceftiaoxime |
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Ceftriaxone |
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Cefuroxime |
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Cephalexin |
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Cephradine |
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Chloramphenicol |
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Ciprofloxacin |
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Clarithromycin |
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Clindamycin |
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Cloxacillin |
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Trimethoprim-Sulfamethoxazole |
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Demeclocycline |
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Dicloxacillin |
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Doripenem |
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Doxycycline |
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Erythromycin |
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Gentamicin |
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Imipenem-Cilastatin |
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Linezolid |
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Loracarbef |
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Meropenem |
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Metronidazole |
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Mezlocillin |
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Mupirocin |
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Nafcillin |
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Nalidixic acid |
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Neomycin |
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Nitrofurantoin Furadantin, Furan, Macrodantin. Capsule: 50, 100 mg. Extended-release capsule: 100 mg. Macrocrystal: 50, 100 mg. Suspension: 25 mg/5 mL. |
Effective in the treatment of lower urinary tract infections caused by gram-positive and 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. |
Cautions: Vertigo, dizziness, rash, jaundice, interstitial pneumonitis. Do not use with moderate to severe renal dysfunction. Drug interactions: Liquid antacids. | |
Ofloxacin Ocuflox 0.3% ophthalmic solution: 1, 5, Floxin 0.3% otic solution: 5, 10 mL. |
Quinolone antibiotic for treatment of conjunctivitis or corneal ulcers (ophthalmic solution) and otitis externa or chronic suppurative otitis media (otic solution) caused by susceptible gram-positive, gram-negative, anaerobic bacteria, or Chlamydia trachomatis. Child 1-12 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 (otic solution): 5 drops into affected ear bid for 10 days. Chronic suppurative otitis media: treat for 14 days. Child 12 yr and adults: Ophthalmic solution doses same as for younger children. Otitis externa (otic solution): Use 10 drops bid for 10 or 14 days as for younger children. |
Adverse events: Burning, stinging, eye redness (ophthalmic solution), dizziness with otic solution if not warmed. | |
Oxacillin sodium Prostaphlin. Injection. Capsule: 250, 500 mg. Suspension: 250 mg/5 mL. |
Penicillinase-resistant penicillin active against S. aureus and other gram-positive cocci, except Enterococcus and coagulase-negative staphylococci. Neonates: Postnatal age ≤7 days 1,200-2,000 g: 50 mg/kg/24 hr divided q 12 hr IV; 2,000 g: 75 mg/kg/24 hr IV divided q 8 hr IV; postnatal age 7 days 1,200 g: 50 mg/kg/24 hr IV divided q 12 hr IV; 1,200-2,000 g: 75 mg/kg/24 hr divided q 8 hr IV; 2,000 g: 100 mg/kg/24 hr IV divided q 6 hr IV. 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). |
Cautions: -Lactam safety profile (rash, eosinophilia). Moderate oral bioavailability (35-65%). Primarily renally eliminated. Drug interaction: Probenecid. Adverse effect: 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, |
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. |