Sandbox g15

Antibiotic Agent	Antimicrobial Spectrum	Dosing Information	Common 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 Abdominal 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 Biaxin. Tablet: 250, 500 mg. Suspension: 125 mg/5 mL, 250 mg/5 mL.	Macrolide antibiotic with activity against S. aureus, Streptococcus, H. influenzae, Legionella, Mycoplasma, and 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).	Cautions: Adverse events less than erythromycin; gastrointestinal upset, dyspepsia, nausea, cramping. Drug interactions: Same as erythromycin: astemizole carbamazepine, terfenadine cyclosporine, theophylline, digoxin, tacrolimus.
Clindamycin Cleocin. Capsule: 75, 150, 300 mg. Suspension: 75 mg/5 mL. Injection. Topical solution, lotion, and gel. Vaginal cream.	Protein synthesis inhibitor active against most gram-positive aerobic and anaerobic cocci except Enterococcus. Neonates: Postnatal age ≤7 days 200 g; 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; 7 days 1,200 g: 10 mg/kg/24 hr IV or IM divided q 12 hr; 1,200-2,000 g: 15 mg/kg/24 hr divided q 8 hr IV or IM; 2,000 g: 20 mg/kg/24 hr divided q 8 hr IV or IM. 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).	Cautions: Diarrhea, nausea, Clostridium difficile–associated colitis, rash. Administer slow IV over 30-60 min. Topically active as an acne treatment.
Cloxacillin sodium Tegopen. Capsule: 250, 500 mg. Suspension: 125 mg/5 mL.	Penicillinase-resistant penicillin active against 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).	Cautions: -Lactam safety profile (rash, eosinophilia). Primarily hepatically eliminated; requires dose reduction in renal disease. Food decreases bioavailability. Drug interaction: Probenecid.
Co-trimoxazole (trimethoprim- sulfamethoxazole; TMP-SMZ) Bactrim, Cotrim, Septra, Sulfatrim. Tablet: SMZ 400 mg and TMP 80 mg. Tablet DS: SMZ 800 mg and TMP 160 mg. Suspension: SMZ 200 mg and TMP 40 mg/5 mL. Injection.	Antibiotic combination with sequential antagonism of bacterial folate synthesis with broad antibacterial activity: Shigella, Legionella, Nocardia, Chlamydia, Pneumocystis jiroveci. Dosage based on TMP component. Children: 6-20 mg TMP/kg/24 hr or IV divided q 12 hr PO. Pneumocystis carinii pneumonia: 15-20 mg TMP/kg/24 hr divided q 12 hr PO or IV. P. carinii prophylaxis: 5 mg TMP/kg/24 hr or 3 times/wk PO. Adults: 160 mg TMP q 12 hr PO.	Cautions: Drug dosed on TMP (trimethoprim) component. Sulfonamide skin reactions: rash, erythema multiforme, Stevens-Johnson syndrome, nausea, leukopenia. Renal and hepatic elimination; reduce dose in renal failure. Drug interactions: Protein displacement with warfarin, possibly phenytoin, cyclosporine.
Demeclocycline Declomycin. Tablet: 150, 300 mg. Capsule: 150 mg.	Tetracycline active against most gram-positive cocci except Enterococcus, many gram-negative bacilli, anaerobes, Borrelia burgdorferi (Lyme disease), Mycoplasma, and Chlamydia. Children: 8-12 mg/kg/24 hr divided q 6-12 hr PO. Adults: 150 mg PO q 6-8 hr. Syndrome of inappropriate antidiuretic hormone secretion: 900- 1,200 mg/24 hr or 13-15 mg/kg/24 hr divided q 6-8 hr PO with dose reduction based on response to 600-900 mg/24 hr.	Cautions: Teeth staining, possibly permanent (if administered 8 yr of age) with prolonged use; photosensitivity, diabetes insipidus, nausea, vomiting, diarrhea, superinfections. Drug interactions: Aluminum-, calcium-, magnesium-, zinc- and iron-containing food, milk, dairy products may decrease absorption.
Dicloxacillin Dynapen, Pathocil. Capsule: 125, 250, 500 mg. Suspension: 62.5 mg/5 mL.	Penicillinase-resistant penicillin active against 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.	Cautions: -Lactam safety profile (rash, eosinophilia). Primarily renally (65%) and bile (30%) elimination. Food may decrease bioavailability. Drug interaction: Probenecid.
Doripenem Doribax. Injection.	Carbapenem antibiotic with broad-spectrum activity against gram-positive cocci and gram-negative bacilli, including P. aeruginosa and anaerobes. Children: dose unknown. Adults: 500 mg q 8 hr IV.	Cautions: -Lactam safety profile; does not undergo hepatic metabolism. Renal elimination (70-75%); dose adjustment for renal failure. Drug interactions: Valproic acid, probenecid.
Doxycycline Vibramycin, Doxy. Injection. Capsule: 50, 100 mg. Tablet: 50, 100 mg. Suspension: 25 mg/5 mL. Syrup: 50 mg/5 mL.	Tetracycline antibiotic active against most gram-positive cocci except Enterococcus, many gram-negative bacilli, anaerobes, B. burgdorferi (Lyme disease), Mycoplasma, and 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.	Cautions: Teeth staining, possibly permanent (8 yr of age) with prolonged use; photosensitivity, nausea, vomiting, diarrhea, superinfections. Drug interactions: Aluminum-, calcium-, magnesium-, zinc-, iron-, kaolin-, and pectin-containing products, food, milk, dairy products may decrease absorption. Carbamazepine, rifampin, barbiturates may decrease half-life.
Erythromycin E-Mycin, Ery-Tab, Ery-C, Ilosone. Estolate 125, 500 mg. Tablet EES: 200 mg. Tablet base: 250, 333, 500 mg. Suspension: estolate 125 mg/5 mL, 250 mg/5 mL, EES 200 mg/5 mL, 400 mg/5 mL. Estolate drops: 100 mg/mL. EES drops: 100 mg/2.5 mL. Available in combination with sulfisoxazole (Pediazole), dosed on erythromycin content.	Bacteriostatic macrolide antibiotic most active against gram- positive organisms, Corynebacterium diphtheriae, and Mycoplasma pneumoniae. Neonates: Postnatal age ≤7 days: 20 mg/kg/24 hr divided q 12 hr PO; 7 days 1,200 g: 20 mg/kg/24 hr divided q 12 hr PO; 1,200 g: 30 mg/kg/24 hr divided q 8 hr PO (give as 5 mg/kg/dose q 6 hr to improve feeding intolerance). 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.	Cautions: Motilin agonist leading to marked abdominal cramping, nausea, vomiting, diarrhea. Associated with hypertrophic pyloric stenosis in young infants. Many different salts with questionable tempering of gastrointestinal adverse events. Rare cardiac toxicity with IV use. Dose of salts differ. Topical formulation for treatment of acne. Drug interactions: Antagonizes hepatic CYP 3A4 activity: astemizole, carbamazepine, terfenadine, cyclosporine, theophylline, digoxin, tacrolimus, carbamazepine.
Gentamicin Garamycin. Injection. Ophthalmic solution, ointment, topical cream.	Aminoglycoside antibiotic active against gram-negative bacilli, especially E. coli, Klebsiella, Proteus, Enterobacter, Serratia, 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 once daily. Intrathecal: Preservative-free preparation for intraventricular or intrathecal use: neonate: 1 mg/24 hr; children: 1-2 mg/24 hr IT; adults: 4-8 mg/24 hr. Adults: 3-6 mg/kg/24 hr divided q 8 hr IV or IM.	Cautions: Anaerobes, S. pneumoniae, and other Streptococcus 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 with intermittent daily dose regimens only.
Imipenem-cilastatin Primaxin. Injection.	Carbapenem antibiotic with broad-spectrum activity against gram-positive cocci and gram-negative bacilli, including P. aeruginosa and anaerobes. No activity against Stenotrophomonas maltophilia. Neonates: Postnatal age ≤7 days 1,200 g: 20 mg/kg q 18-24 hr IV or IM; 1,200 g: 40 mg/kg divided q 12 hr IV or IM; postnatal age 7 days 1,200-2,000 g: 40 mg/kg q 12 hr IV or IM; 2,000 g: 60 mg/kg q 8 hr IV or IM. 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).	Cautions: -Lactam safety profile (rash, eosinophilia), nausea, seizures. Cilastatin possesses no antibacterial activity; reduces renal imipenem metabolism. Primarily renally eliminated. Drug interaction: Possibly ganciclovir.
Linezolid Zyvox. Tablet: 400, 600 mg. Oral suspension: 100 mg/5 mL. Injection: 100 mg/5 mL.	Oxazolidinone antibiotic active against gram-positive cocci (especially drug-resistant organisms), including Staphylococcus, Streptococcus, E. faecium, and Enterococcus faecalis. Interferes with protein synthesis by binding to 50S ribosome subunit. Children: 10 mg/kg q 12 hr IV or PO. Adults: Pneumonia: 600 mg q 12 hr IV or PO; skin infections: 400 mg q 12 hr IV or PO.	Adverse events: Myelosuppression, pseudomembranous colitis, nausea, diarrhea, headache. Drug interaction: Probenecid.
Loracarbef Lorabid. Capsule: 200 mg. Suspension: 100 mg/5 mL, 200 mg/5 mL.	Carbacephem very closely related to cefaclor (2nd generation cephalosporin) active against S. aureus, Streptococcus, H. influenzae, M. catarrhalis, E. coli, Klebsiella, and 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).	Cautions: -Lactam safety profile (rash, eosinophilia). Renally eliminated. Drug interaction: Probenecid.
Meropenem Merrem. Injection.	Carbapenem antibiotic with broad-spectrum activity against gram-positive cocci and gram-negative bacilli, including P. aeruginosa and anaerobes. No activity against Stenotrophomonas maltophilia. Children: 60 mg/kg/24 hr divided q 8 hr IV meningitis: 120 mg/ kg/24 hr (max dose: 6 g/24 hr) q 8 hr IV. Adults: 1.5-3 g q 8 hr IV.	Cautions: -Lactam safety profile; appears to possess less CNS excitation than imipenem. 80% renal elimination. Drug interaction: Probenecid.
Metronidazole Flagyl, Metro-IV, generic. Topical gel, vaginal gel. Injection. Tablet: 250, 500 mg.	Highly effective in the treatment of infections due to anaerobes. Neonates: 1,200 g: 7.5 mg/kg 48 hr PO or IV; postnatal age ≤7 days 1,200-2,000 g: 7.5 mg/kg/24 hr q 24 hr PO or IV; 2,000 g: 15 mg/ kg/24 hr divided q 12 hr PO or IV; postnatal age 7 days 1,200-2,000 g: 15 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. 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).	Cautions: Dizziness, seizures, metallic taste, nausea, disulfiram-like reaction with alcohol. Administer IV slow over 30-60 min. Adjust dose with hepatic impairment. Drug interactions: Carbamazepine, rifampin, phenobarbital may enhance metabolism; may increase levels of warfarin, phenytoin, lithium.
Mezlocillin sodium Mezlin. Infection.	Extended-spectrum penicillin active against E. coli, Enterobacter, Serratia, and Bacteroides; limited antipseudomonal activity. Neonates: Postnatal age ≤7 days: 150 mg/kg/24 hr divided q 12 hr IV; 7 days: 225 mg/kg divided q 8 hr IV. Children: 200-300 mg/kg/24 hr divided q 4-6 hr IV; cystic fibrosis 300-450 mg/kg/24 hr IV. Adults: 2-4 g/dose q 4-6 hr IV (max dose: 12 g/24 hr).	Cautions: -Lactam safety profile (rash, eosinophilia); painful given intramuscularly; each gram contains 1.8 mEq sodium. Interferes with platelet aggregation with high doses; increases noted in liver function test results. Renally eliminated. Inactivated by -lactamase enzyme. Drug interaction: Probenecid.
Mupirocin Bactroban. Ointment.	Topical antibiotic active against Staphylococcus and Streptococcus. Topical application: Nasal (eliminate nasal carriage) and to the skin 2-4 times per day.	Caution: Minimal systemic absorption as drug metabolized within the skin.
Nafcillin sodium Nafcil, Unipen. Injection. Capsule: 250 mg. Tablet: 500 mg.	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 or IM; 2,000 g: 75 mg/kg/24 hr divided q 8 hr IV or IM; postnatal age 7 days 1,200-2,000 g: 75 mg/kg/q 8 hr; 2,000 g: 100 mg/kg divided q 6-8 hr IV (meningitis: 200 mg/ kg/24 hr divided q 6 hr IV). 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).	Cautions: -Lactam safety profile (rash, eosinophilia), phlebitis; painful given intramuscularly; oral absorption highly variable and erratic (not recommended). Adverse effect: Neutropenia.
Nalidixic acid NegGram. Tablet: 250, 500, 1,000 mg. Suspension: 250 mg/5 mL.	1st generation quinolone effective for short-term treatment of lower urinary tract infections caused by E. coli, Enterobacter, Klebsiella, and 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.	Cautions: Vertigo, dizziness, rash. Not for use in systemic infections. Drug interactions: Liquid antacids.
Neomycin sulfate Mycifradin, generic. Tablet: 500 mg. Topical cream, ointment. Solution: 125 mg/5 mL.	Aminoglycoside antibiotic used for topical application or orally before surgery to decrease gastrointestinal flora (nonabsorbable) and hyperammonemia. 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.	Cautions: In patients with renal dysfunction because small amount absorbed may accumulate. Adverse events: Primarily related to topical application, abdominal cramps, diarrhea, rash. Aminoglycoside ototoxicity and nephrotoxicity if absorbed.
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, 10 mL. 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, 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.