doses commonly prescribed antibiotics
TRANSCRIPT
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Table 1323. USUAL DOSES OF COMMONLY PRESCRIBED ANTIBIOTICS
DRUG
ADULT DOSEPEDIATRIC
(AGE > 1 MO) DOSE
DOSE IN RENALFAILUREa (CrCl< 10 mL/min)ORAL PARENTERAL
SERIOUSINFECTIONS ORAL PARENTERAL
Aminoglycosides
Amikacin N/A 15 mg/kgIV once/day
or7.5 mg/kg q 12 h
15 mg/kgIV once/day
or7.5 mg/kg IV q 12 h
N/A 57.5 mg/kg IVq 12 h
1.52.5 mg/kg IVq 2448 h
Gentamicin N/A 57 mg/kgIV once/day
or1.7 mg/kg IV q 8 h
57 mg/kgIV once/day
N/A 12.5 mg/kg IVq 8 h
0.340.51 mg/kg IVq 2448 h
For synergy witha cell wallactiveantibiotic to treatenterococcal en-docarditis causedby strains suscepti-ble to gentamicin
N/A 1 mg/kg IV q 8 h N/A N/A 1 mg/kg IV q 8 h Infectious disease con-sultation required fordosage
Dosage adjusted toachieve peak serumconcentration of34 g/mL andtrough concentration
of
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For hepatic coma 13 g qid N/A N/A 0.61.75 g/m2q 6 h
or
0.41.2 g/m2q 4 h
N/A N/A
Streptomycin
For TB N/A 15 mg/kg IM q 24 h(maximum: 1.0 g/day) initially, then1.0 g 23 times/wk
N/A N/A 2040 mg/kg IMonce/day
7.5 mg/kg IMq 7296 h(maximum: 1 g)
For synergy with acell wallactiveantibiotic to treatenterococcalendocarditis
N/A 7.5 mg/kg IM q 12 h N/A N/A N/A N/A
Tobramycin N/A 57 mg/kgIV once/day
or
1.7 mg/kg IV q 8 h
57 mg/kg IVonce/day
or
1.7 mg/kg IV q 8 h
N/A 12.5 mg/kg IVq 8 h
0.340.51 mg/kg IVq 2448 h
-Lactams: Cephalosporins (1st generation)
Cefadroxil 0.51 g q 12 h N/A N/A 15 mg/kg q 12 h N/A 0.5 g po q 36 h
Cefazolin N/A 12 g IV q 8 h 2 g IV q 8 h N/A 16.633.3 mg/kg IVq 8 h
12 g IVq 2448 h
Cephalexin 0.250.5 gq 6 h
N/A N/A 6.2512.5 mg/kg q 6 hor
8.016 mg/kg q 8 h
N/A 0.250.5 g poq 2448 h
Table 1323. USUAL DOSES OF COMMONLY PRESCRIBED ANTIBIOTICS(Continued)
DRUG
ADULT DOSEPEDIATRIC
(AGE > 1 MO) DOSE
DOSE IN RENALFAILUREa (CrCl< 10 mL/min)ORAL PARENTERAL
SERIOUSINFECTIONS ORAL PARENTERAL
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-Lactams: Cephalosporins (2nd generation)
Cefaclorb 0.250.5 gq 8 h
N/A N/A 1020 mg/kg q 12 hor
6.613.3 mg/kg q 8 h
N/A 0.5 g po q 12 h
Cefotetan N/A 13 g IV q 12 h 23 g IVq 12 h
N/A 2040 mg/kg IVq 12 h
13 g IV q 48 h
Cefoxitin N/A 1 g IV q 8 h to 2 gIV q 4 h
2 g IV q 4 hor
3 g IV q 6 h
N/A 2733 mg/kg IV q 8 hor, for severe infec-tions, 2540 mg/kgq 6 h
0.51.0 g IVq 2448 h
Cefprozil 0.25 g q 12 hor
0.5 g q 1224 h
N/A N/A 15 mg/kg q 12 h forotitis media
N/A 0.25 g po q 1224 h
Cefuroxime 0.1250.5 gq 12 h
0.751.5 g IVq 68 h
1.5 g IV q 6 h 1015 mg/kg suspensionq 12 h
For older children:
125250 mg tabletsq 12 h
2550 mg/kg IVq 8 h
0.250.5 g po q 24 hor
0.75 g IV q 24 h
For meningitis 3 g IV q 8 h 5060 mg/kg IV q 6 h
-Lactams: Cephalosporins (3rd generation)
Cefoperazone N/A 1 g q 12 h to 2 g IVq 4 h
2 g IV q 4 h N/A 25100 mg/kg IVq 12 h
Same as adult dose
Cefotaxime N/A 1 g q 12 h to 2 g IVq 4 h
2 g IV q 4 h N/A 8.333.3 mg/kg IVq 4 h
or16.666.6 mg/kg q 6 h
12 g IV q 24 h
Table 1323. USUAL DOSES OF COMMONLY PRESCRIBED ANTIBIOTICS(Continued)
DRUG
ADULT DOSEPEDIATRIC
(AGE > 1 MO) DOSE
DOSE IN RENALFAILUREa (CrCl< 10 mL/min)ORAL PARENTERAL
SERIOUSINFECTIONS ORAL PARENTERAL
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Cefpodoximec 0.10.4 g q 12 h N/A N/A 5 mg/kg q 12 h N/A 0.10.4 g po q 24 h
Ceftazidime N/A 1 g IV q 12 h to 2 gq 8 h
2 g IV q 8 h N/A 2550 mg/kg IVq 8 h
0.5 g IV q 2448 h
Ceftibutenb 0.4 g q 24 h N/A N/A 9 mg/kg once/day N/A 0.1 g po q 24 h
Ceftizoxime N/A 0.5 g IV q 12 h to4 g IV q 8 h
4 g IV q 8 h N/A 50 mg/kg IVq 68 h
0.5 g IV q 24 h to0.51 g IV q 48 h
Ceftriaxone N/A 12 g IV q 24 h 2 g IV q 24 h N/A 5075 mg/kg IV q 24 hor
2537.5 mg/kg q 12 h
Same as adult dose
For meningitis N/A 2 g IV q 12 h 2 g IV q 12 h N/A 50 mg/kg IV q 12 h or100 mg/kg q 24 h (notto exceed 4 g/day)
Possibly a loadingdose of 100 mg/kgIV (not to exceed 4 g)at the start of therapy
2 g IV q 12 h
-Lactams: Cephalosporin (4th generation)
Cefepime N/A 12 g IV q 812 h 2 g IV q 8 h N/A 50 mg/kg IV q 812 h 0.251 g IV q 24 h
-Lactams: Penicillins
Amoxicillin 0.250.5 g q 8 hor
0.875 g q 12 h
N/A N/A 12.525 mg/kg q 12 hor
713 mg/kg q 8 h
N/A 0.250.5 g po q 24 h
For endocarditisprophylaxis
2 g for 1 dose N/A N/A 50 mg/kg 1 h beforeprocedure
N/A 2 g po for 1 dose
Amoxicillin/clavulanate
0.250.5 g q 8 hor
0.875 g q 12 h
N/A N/A If >40 kg: Adult dose N/A 0.250.5 g po q 24 h
Table 1323. USUAL DOSES OF COMMONLY PRESCRIBED ANTIBIOTICS(Continued)
DRUG
ADULT DOSEPEDIATRIC
(AGE > 1 MO) DOSE
DOSE IN RENALFAILUREa (CrCl< 10 mL/min)ORAL PARENTERAL
SERIOUSINFECTIONS ORAL PARENTERAL
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Amoxicillin/clavu-lanate, ES-600
N/A N/A N/A 45 mg/kg q 12 h N/A N/A
Amoxicillin/clavu-lanate, extended-release
2 g q 12 h N/A N/A N/A N/A N/A
Ampicillin N/A 0.52.0 g IV q 46 h 2 g IV q 4 h N/A 2550 mg/kg IV q 6 h 0.52.0 g IV q 1224 h
For meningitis N/A 2 g IV q 4 h 2 g IV q 4 h N/A 50100 mg/kg IVq 6 h
2 g IV q 12 h
Ampicillin/sulbactam(3 g=2 g ampicillin+1 g sulbactam)
N/A 1.53.0 g IV q 6 h 3 g IV q 6 h N/A 2550 mg/kg IV q 6 h 1.53.0 g IV q 24 h
Dicloxacillinb 0.1250.5 g q 6 h N/A N/A 3.1256.25 mg/kg q 6 h N/A 0.1250.5 g po q 6 h
Nafcillin Rarely used 12 g IV q 4 h 2 g IV q 4 h N/A 12.525 mg/kg IVq 6 h
or
8.333.3 mg/kg q 4 h
12 g IV q 4 h
Oxacillin Rarely used 12 g IV q 4 h 2 g IV q 4 h N/A 12.525 mg/kg IVq 6 h
or8.333.3 mg/kg IVq 4 h
12 g IV q 4 h
Penicillin Gb 0.250.5 g
q 612 h(penicillin V)
14 million units IV
q 46 h
4 million units IV
q 4 h
Penicillin VK
6.2512.5 mg/kgq 8 h
6,250100,000 units/
kg IV q 6 hor4,166.666,666units/kg IV q 4 h
0.52 million units
IV q 46 h(maximum totaldaily dose: 6 millionunits/day)
Table 1323. USUAL DOSES OF COMMONLY PRESCRIBED ANTIBIOTICS(Continued)
DRUG
ADULT DOSEPEDIATRIC
(AGE > 1 MO) DOSE
DOSE IN RENALFAILUREa (CrCl< 10 mL/min)ORAL PARENTERAL
SERIOUSINFECTIONS ORAL PARENTERAL
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Penicillin G ben-zathine(Bicillin
L-A)For streptococcal
pharyngitisN/A 1.2 million units IM
for 1 doseN/A N/A 25,00050,000 units/
kg IM as a single doseor
If 1 MO) DOSE
DOSE IN RENALFAILUREa (CrCl< 10 mL/min)ORAL PARENTERAL
SERIOUSINFECTIONS ORAL PARENTERAL
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Piperacillin/tazo-bactam(2.25 g =2.0 g piperacillin +
0.25 g tazobactam)
N/A 3.375 g IV q 46 h 3.375 g IV q 4 h N/A 80 mg/kg IV q 8 h 2.25 g IV q 8 h to 4.5 gIV q 12 h
Ticarcillin(5.2 mEq Na/g)
N/A 3 g IV q 46 h 3 g IV q 4 h N/A If 1 MO) DOSE
DOSE IN RENALFAILUREa (CrCl< 10 mL/min)ORAL PARENTERAL
SERIOUSINFECTIONS ORAL PARENTERAL
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Extended-release
for uncomplicatedcystitis
0.5 g q 24 h for
3 days
N/A N/A N/A N/A N/A
Gemifloxacin 320 mg q 24 h N/A N/A N/A N/A 160 mg po q 24 h
Levofloxacin 0.250.75 gq 24 h
0.250.75IV g q 24 h
0.75 g IV q 24 h N/A N/A 0.250.5 g po or IVq 48 h
Moxifloxacin 0.4 g q 24 h 0.4 g IV q 24 h 0.4 g IV q 24 h N/A N/A 0.4 g q 24 h po or IV
Norfloxacinb 0.4 g q 12 h N/A N/A N/A N/A 0.4 g po q 24 h
Ofloxacin 0.20.4 g q 12 h 0.4 g IV q 12 h 0.20.4 g IV q 12 h N/A N/A 0.10.2 g po or IVq 24 h
Macrolides
Azithromycin 0.5 g on day 1,then 0.25 g q24 h for 4 days
0.5 g IV q 24 h 0.5 g IV q 24 h N/A 0.5 g on day 1, then0.25 g po q 24 h for 4days or 0.5 g IV q 24 h
For nongonococcalcervicitis andurethritis
1 g for 1 dose N/A N/A N/A N/A N/A
For travelersdiarrhea
1 g for 1 dose N/A N/A 510 mg/kg for1 dose
N/A N/A
For tonsillitis orpharyngitis
N/A N/A N/A 12 mg/kg for 5 days N/A N/A
For otitis mediaor community-acquired pneumonia
N/A N/A N/A 10 mg/kg on day 1,then 5 mg/kg once/dayon days 25
N/A N/A
Table 1323. USUAL DOSES OF COMMONLY PRESCRIBED ANTIBIOTICS(Continued)
DRUG
ADULT DOSEPEDIATRIC
(AGE > 1 MO) DOSE
DOSE IN RENALFAILUREa (CrCl< 10 mL/min)ORAL PARENTERAL
SERIOUSINFECTIONS ORAL PARENTERAL
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Clarithromycin 0.250.5 g q 12 hExtended-re-lease: 1 g q 24 h
N/A N/A 7.5 mg/kg q 12 h N/A 0.250.5 g po q 24 h
Dirithromycin 0.5 g q 24 h N/A N/A N/A N/A 0.5 g po q 24 h
Erythromycinbaseb
0.250.5 gq 6 h
N/A N/A 1016.6 mg/kg q 8 hor
7.512.5 mg/kg q 6 h
N/A 0.25 g po q 6 h
Lactobionate N/A 0.51 g IV q 6 h 1 g IV q 6 h N/A 3.755.0 mg/kg IVq 6 h
0.5 g IV q 6 h
Gluceptate N/A 0.51 g IV q 6 h 1 g IV q 6 h N/A 3.755.0 mg/kg IVq 6 h 0.5 g IV q 6 h
For GI preoperativebowel preparation
1 g for3 doses
N/A N/A 20 mg/kg for 3 doses N/A N/A
Telithromycin 800 mg q 24 h N/A N/A N/A N/A 800 mg po q 24 h
Sulfonamides and trimethoprim
Sulfisoxazole 1.0 g q 6 h 25 mg/kg IV q 6 h (not
available in US)
N/A 3037.5 mg/kg q 6 h
or2025 mg/kg q 4 h
N/A 1 g po q 1224 h
Sulfamethizole 0.51 g q 68 h N/A N/A 7.511.25 mg/kg q 6 h N/A N/A
Sulfamethoxazole 1 g q 812 h N/A N/A 2530 mg/kg q 12 h N/A 1 g po q 24 h
Trimethoprim 0.1 g q 12 hor
0.2 g q 24 h
N/A N/A 2 mg/kg q 12 h for10 days for UTI
N/A 0.1 g po q 24 h
Trimethoprim/sulfamethoxazolee
0.16/0.8 g q 12 h 35 mg TMP/kg IVq 68 h
5 mg TMP/kg IVq 6 h
36 mg TMP/kgq 12 h
36 mg TMP/kg IVq 12 h
(Not recommended ifother alternatives areavailable)
Table 1323. USUAL DOSES OF COMMONLY PRESCRIBED ANTIBIOTICS(Continued)
DRUG
ADULT DOSE PEDIATRIC(AGE > 1 MO) DOSE
DOSE IN RENALFAILUREa (CrCl< 10 mL/min)ORAL PARENTERAL
SERIOUSINFECTIONS ORAL PARENTERAL
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For Pneumocystisjirovecii pneumo-niae
0.32/1.6 g q 8 hfor 21 days
5 mg TMP/kg IVq 8 h for 21 days
5 mg TMP/kg IVq 68 h
56.6 mg TMP/kg q 8 hor
3.755 mg TMP/kg q 6 h
56.6 mg TMP/kg IVq 8 h
or
3.755 mg TMP/kgIV q 6 h
If essential, 5 mgTMP/kg IV q 24 h
or
1.25 mg TMP/kg IVq 6 h
Tetracyclines
Doxycycline 0.1 g q 12 h 0.1 g IV q 12 h 0.1 mg IV q 12 h Age >8 yr: 24 mg/kgq 24 h
or12 mg/kg q 12 h
Age >8 yr: 24 mg/kg IV q 24 h
or12 mg/kg IV q 12 h
0.1 g IV or po q 12 h
Minocycline 0.1 g q 12 h 0.1 g IV q 12 h 0.1 g IV q 12 h N/A N/A 0.1 g IV or po q 12 hTetracyclineb 0.250.5 g
q 6 hN/A N/A Age >8 yr: 6.2512.5
mg/kg q 6 hN/A Doxycycline used
instead
Tigecycline N/A 100 mg, then 50 mg(25 mg for severehepatic dysfunc-tion) IV q 12 hr
Same as adult dose N/A N/A Same as adult dose
OthersClindamycin 0.150.45 g
q 6 h0.6 g IV q 6 h to 0.9IV g q 8 h
0.9 g IV q 8 h 2.66.6 mg/kg q 8 hor
25 mg/kg q 6 h
6.613.2 mg/kg IVq 8 h
or510 mg/kg IV q 6 h
0.150.45 g po q 6 hor
0.60.9 g IV q 68 h
Chloramphenicol 0.251 g q 6 h 0.251.0 g IV q 6 h 1 g IV q 6 h N/A 12.518.75 mg/kgIV q 6 h
0.251.0 g IV q 6 h
For meningitis N/A 12.5 mg/kg q 6 h(maximum: 4 g/day)
12.5 mg/kg IVq 6 h (maximum:4 g/day)
N/A 18.7525 mg/kg IVq 6 h
12.5 mg/kg IV q 6 h(maximum: 4 g/day)
Daptomycin N/A 4 mg/kg IV q 24 h 4 mg/kg IV q 24 h N/A N/A 4 mg/kg IV q 48 h
Table 1323. USUAL DOSES OF COMMONLY PRESCRIBED ANTIBIOTICS(Continued)
DRUG
ADULT DOSE
PEDIATRIC
(AGE > 1 MO) DOSEDOSE IN RENALFAILUREa (CrCl< 10 mL/min)ORAL PARENTERAL
SERIOUSINFECTIONS ORAL PARENTERAL
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Linezolid 0.6 g q 12 h 0.6 g IV q 12 h 0.6 g IV q 12 h 10 mg/kg q 8 h 10 mg/kg IV q 8 h 0.6 g IV or po q 12 h
MetronidazoleFor anaerobic
infection7.5 mg/kg q 6 h
(not to exceed4 g/day)
7.5 mg/kg IVq 6 h (not toexceed 4 g/day)
7.5 mg/kg IVq 6 h (not toexceed 4 g/day)
7.5 mg/kg q 6 h 7.5 mg/kg IV q 6 h 3.75 mg/kg IV or poq 6 h (not to exceed2 g/day)
For trichomoniasis 2 g for 1 doseor
0.5 g q 12 h for7 days
N/A N/A N/A N/A N/A
For Clostridiumdifficileinduceddiarrhea (pseudo-membranous coli-tis)
0.5 g q 68 h for1014 days
500 mg IV q 68 h 500 mg IV q 6 h 7.5 mg/kg q 8 h 7.5 mg/kg IV q 6 h 250 mg po or IV q 8 h
For amebiasis 0.50.75 g q 8 hfor 10 days fol-
lowed by paro-momycin po0.5 g q 8 h for7 days
0.75 g IV q 8 h for10 days followed
by paromomycinpo 0.5 g q 8 h for7 days
0.75 g IV q 8 hfor 10 days
followed by paro-momycin po 0.5 g q8 h for 7 days
11.616.6 mg/kgq 8 h for 710 days
11.616.6 mg/kgIV q 8 h for 710
days
N/A
For giardiasis 0.25 g q 68 hfor 57 days
N/A N/A 5 mg/kg q 68 hfor 5 days
N/A N/A
Nitrofurantoinmacrocrystals
50100 mgq 6 h
N/A N/A 1.251.75 mg/kgq 6 h
N/A Not recommended
Nitrofurantoinmonohydrate/macrocrystals
100 mg q 12 h N/A N/A N/A N/A N/A
Table 1323. USUAL DOSES OF COMMONLY PRESCRIBED ANTIBIOTICS(Continued)
DRUG
ADULT DOSEPEDIATRIC
(AGE > 1 MO) DOSE
DOSE IN RENALFAILUREa (CrCl< 10 mL/min)ORAL PARENTERAL
SERIOUSINFECTIONS ORAL PARENTERAL
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Quinupristin/
dalfopristin
N/A 7.5 mg/kg IV
q 812 h
7.5 mg/kg IV q 8 h N/A 7.5 mg/kg IV q 12 h
for complicated skinor skin structureinfection
or7.5 mg/kg q 8 h for
serious infections
7.5 mg/kg IV q 812 h
Rifampinb
For TB 0.6 g q 24 h 0.6 g IV q 24 h N/A 510 mg/kg q 12 h
or1020 mg/kg q 24 h
1020 mg/kg IV
q 24 h
0.30.6 g IV or po
q 24 h
For meningococcalexposure
0.6 g q 12 h for4 doses
N/A N/A Age 1 mo: 10 mg/kgq 12 h for 2 days
Age
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Vancomycin 125 mg q 6 h(only effective
for C. difficileinduceddiarrhea
15 mg/kg q 12 h(often 1 g q 12)
15 mg/kg IV q 12 h N/A 13 mg/kg IV q 8 hor
10 mg/kg q 6 h
0.51.0 g IV q wk
For meningitis N/A 1 g IV q 8 hor
1.5 g IV q 12 hf
1 g IV q 8 hor
1.5 g IV q 12 h
N/A 15 mg/kg IV q 6 h 15 mg/kg IV q wk
a
Initial loading dose should be equivalent to the usual dose for patients with normal renal function, followed by a dose adjusted for renal failure. Dosing adjustmentsof aminoglycosides should be assisted by measuring peak (drawn 1 h after the start of a 30-min IV infusion) and trough (drawn 30 min before next dose) serum levels.bRate or extent of absorption is decreased when the drug is taken with food.cDosage should not exceed that for adults.dThese drugs are generally avoided in children.eDose is based on TMP.fIn addition, intrathecal or intraventricular vancomycin 1020 mg/day may be necessary, and dose may need to be adjusted to achieve trough CSF levels of 1020
g/mL.
N/A =not applicable; TMP =trimethoprim.
Table 1323. USUAL DOSES OF COMMONLY PRESCRIBED ANTIBIOTICS(Continued)
DRUG
ADULT DOSEPEDIATRIC
(AGE > 1 MO) DOSE
DOSE IN RENALFAILUREa (CrCl< 10 mL/min)ORAL PARENTERAL
SERIOUSINFECTIONS ORAL PARENTERAL
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