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
|
|
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.
|
|
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
|
|
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)
|
|
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-like reaction
|
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
|
|
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)
|
|
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
|
|
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
|
|
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)
|
|
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)
|
|
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)
|
|
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)
|
|
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)
|
|
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)
|
|
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)
|
|
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)
|
|
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)
|
|
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)
|
|
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)
|
|
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
|
|
Doripenem
|
- Gram-positive cocci
- Gram-negative bacilli including P. aeruginosa
- Anaerobes
|
|
|
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)
|
|
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
|
|
Metronidazole
|
|
- 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
|
|
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
|
|
Neomycin
|
|
- 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
|
- S. pneumoniae
- Group A Streptococcus
- N. gonorrhoeae
- N. meningitidis
|
- Neonates (postnatal age ≤ 7 days): 50,000 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 (> 2,000 g)
- Neonates (postnatal age > 7 days): 50,000 units/kg/24 hr divided q 12 hr IV (< 1,200 g); 75,000 units/kg/24 hr q 8 hr IV (1,200–2,000 g); 100,000 units/kg/24 hr divided q 6 hr IV (> 2,000 g)
- 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
|
- Rash
- Eosinophilia
- Allergy
- Seizures
|
Penicillin G, benzathine
|
|
- Neonates: 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
|
- Rash
- Eosinophilia
- Allergy
|
Penicillin G, procaine
|
|
- Neonates: 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)
- Adults: 0.6-4.8 million units q 12-24 hr IM
|
- Rash
- Eosinophilia
- Allergy
|
Penicillin V
|
- S. pneumoniae
- 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)
|
- Rash
- Eosinophilia
- Allergy
|
Piperacillin
|
- E. coli
- Enterobacter
- Serratia
- P. aeruginosa
- Bacteroides
|
- Neonates (postnatal age ≤ 7 days):150 mg/kg/24 hr divided q 8-12 hr IV
- Neonates (postnatal age > 7 days): 200 mg/kg divided q 6-8 hr IV
- Children: 200-300 mg/kg/24 hr divided q 4-6 hr IV
- Adults: 2-4 g/dose q 4-6 hr (max dose: 24 g/24 hr) IV
|
- Rash
- Eosinophilia
- Serum sickness-like reaction
|
Piperacillin-Tazobactam
- S. aureus
- H. influenzae
- E. coli
- Enterobacter
- Serratia
- Acinetobacter
- P. aeruginosa
- Bacteroides
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- 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
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Quinupristin/dalfopristin
Synercid.
IV injection: powder for reconstitution, 10 mL contains 150 mg quinupristin,
350 mg dalfopristin.
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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.
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Adverse events: Pain, edema, or phlebitis at injection site, nausea, diarrhea.
Drug interactions: Synercid is a potent inhibitor of CYP 3A4.
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Sulfadiazine
Tablet: 500 mg.
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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.
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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.
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Sulfamethoxazole
Gantanol. Tablet: 500 mg.
Suspension: 500 mg/5 mL.
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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).
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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.
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Sulfisoxazole Gantrisin. Tablet: 500 mg.
Suspension: 500 mg/5 mL. Ophthalmic solution, ointment.
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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.
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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.
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Ticarcillin Ticar. Injection.
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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).
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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.
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Ticarcillin-clavulanate
Timentin. Injection.
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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).
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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.
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Tigecycline Tygacil. Injection.
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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.
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Cautions: Pregnancy; children under 8 yr of age; photosensitivity; hypersensitivity to tetracyclines; hepatic impairment (~60% hepatic clearance).
Drug interaction: Warfarin; mycophenolate mofetil.
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Tobramycin Nebcin, Tobrex. Injection.
Ophthalmic solution, ointment.
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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.
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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.
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Trimethoprim Proloprim, Trimpex. Tablet: 100, 200 mg
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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.
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Cautions: Megaloblastic anemia, bone marrow suppression, nausea, epigastric distress, rash.
Drug interactions: Possible interactions with phenytoin, cyclosporine, rifampin, warfarin.
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Vancomycin Vancocin, Luphocin. Injection.
Capsule: 125 mg, 250 mg. Suspension.
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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.
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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.
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