Antibiotics (other)
|
Aztreonam
Azactam ® | [Mild
infection]
(i.e. UTI): 500mg to 1 gram IV q8-12h.
[Usual dose]: 1-2 grams IV q8-12h.
[Severe/life threatening infection]: 2 grams IV q6-8h.
[Maximum dose]: 8 grams/day.
Renal dosing: [CRCL >30 ml/min]: no change.
[10-30 ml/min]: Loading dose: 1-2 grams x 1, then give 50% of the
usual dose (e.g. 0.5 – 1 gm) q6-12h. [<10 ml/min]: 1–2
grams x 1, then 25% of usual dose (e.g. 250-500 mg) q6-12 hours.
Hemodialysis: 1 – 2 grams x 1, then 25% of usual dose
q6-12h. (e.g., 250-500 mg q6-12 hours). For serious or
life-threatening infections, give an additional 125mg after each
hemodialysis session (1/8th of the usual dose). PD: 1 – 2
grams x 1, then 25% of usual dose q6-12h. (e.g., 250-500 mg q6-12
hours). |
TMP/SMX
Bactrim ® | Dosing: (IV):
8-10mg/kg/day divided q6-12h.
PCP: 15-20mg/kg/day in 3 or 4 divided doses.
(Oral): UTI: 1 DS tab (160mg TMP/800mg SMX) po q12h.
Renal Dosing: [>30 ml/min]: no change . [15-30] 50% of usual
regimen. Alternatively: 8-10mg/kg/day divided q12h x 1-2 days, then
4-6mg/kg q24h. [<15] not recommended by
manufacturer. Alternatively: Non PCP: 8-12
mg/kg/dose q48h (or 4-6 mg/kg/day divided q12-24h) .
PCP: 15-20 mg/kg/dose q48h (or 7-10 mg/kg/day divided q12-24h).
Hemodialysis: Not recommended by manufacturer. |
Chloramphenicol
Chloromycetin ® | Dosing: 12.5 mg/kg
q6h.
[Severe infections]: 25 mg/kg q6h.
Renal Dosing: No adjustments needed. Hemodialysis:
No adjustments needed. |
Clindamycin
Cleocin ® | Dosing: (IV)
300 to 900
mg q6-8h.
(Oral): 150 to 450 mg q6h.
Renal Dosing: No adjustments required. |
| Dapsone: | Dosing: 100 mg po qd.
[PCP]: 100mg po qd.
[Dermatitis herpetiformis]: 50-300 mg qd.
Renal Dosing: Specific guidelines are not available |
Daptomycin
Cubicin ® |
Cyclic Lipopeptide. Dosing
(adults): Skin and/or skin structure infections
(complicated): 4 mg/kg IV once daily for 7-14 days. Bacteremia, endocarditis (unlabeled use):
6 mg/kg IV once daily. Renal Dosing:
Crcl <30 mL/min: 4 mg/kg every 48 hours.
Hemodialysis (administer after hemodialysis)
and/or CAPD: 4 mg/kg every 48 hours.
Supplied: 250 mg, 500 mg
(Injection - powder for reconstitution)
|
Ertapenem
Invanz ® | Dosing: Usual dose:
1 gram IM or IV qd.
Renal Dosing: [CRCL > 30]: No changes. [</= 30]: 500 mg IV/IM qd. Hemodialysis: 500 mg IV/IM
qd. Give supplementary
dose of 150 mg following the hemodialysis session if the 500mg dose
was administered <6 hours prior to hemodialysis. |
Imipenem/
cilastatin
Primaxin ® | Dosing:
250mg to 1gm
q6h
(Maximum dose is 50mg/kg/day or 4 grams/day, whichever is lowest .
Give in divided doses)
Renal Dosing:
[CRCL >71]: No changes. [41 –70 ]: Max 37.5 mg/kg/day
or 3 grams/day. (Range: 9.4 – 37.5mg/kg/day) divided q6-8h.
[21-40]: Max 25 mg/kg/day or 2 grams/day. (Range: 6.25 – 25
mg/kg/day) divided q6-12h. [6-20 ]: Max 12.5 mg/kg/day (max dose
1 gram/day). Range: 6.25 – 12.5 mg/kg/day) divided q12h.
(Usual: 250mg q12h).
Hemodialysis: 125 – 500 mg q12h. (Max
12.5 mg/kg/day). Give dose after dialysis. PD: 125 – 250 mg
q12h |
Linezolid
Zyvox ® | Dosing:
vancomycin-resistant Enterococcus faecium (VRE)
infections: Oral, IV: 600 mg every 12
hours for 14-28 days. Nosocomial pneumonia, complicated skin and
skin structure infections, community-acquired pneumonia including concurrent
bacteremia: Oral, IV: 600 mg every 12 hours for 10-14 days.
Uncomplicated skin and skin structure
infections: Oral: 400 mg every 12 hours for 10-14 days.
Renal Dosing: no adjustment necessary.
(Two primary metabolites of linezolid may accumulate in patients with
renal insufficiency- more studies are needed to determine the clinical
significance). Hemodialysis: No adjustment
necessary. On dialysis days, schedule dose after dialysis. (~30%
extraction).
Important
Drug Interactions:
Linezolid is a
reversible, nonselective inhibitor of monoamine oxidase
(MOA), and a potential interaction with adrenergic or serotonergic
agents is possible. A significant pressor response was observed
when administered with tyramine; therefore, patients should avoid
consuming food or beverages containing tyramine.14,15 More
commonly used agents such as dopamine (Intropin), epinephrine, or
decongestants containing pseudoephedrine may also produce an
exaggerated pressor response. In healthy normotensive subjects
receiving linezolid and pseudoephedrine, the mean maximum increase
in systolic blood pressure was 32 mm Hg.11 Maximum elevation
occurred at two to three hours and returned to baseline within
three hours. No affect on heart rate was observed. Careful dosing
titration is recommended when initiating dopamine or
epinephrine.14
The potential for a
serotonergic interaction with dextromethorphan (Robitussin DM) was
evaluated in healthy subjects. No serotonin syndrome effects
(confusion, delirium, tremors, restlessness, hyperpyrexia, or
diaphoresis) were observed with this combination.14 No effects of
serotonin syndrome were observed during a phase III study of 52
patients comparing fluoxetine, paroxetine and sertraline with
linezolid.18 Nevertheless, caution is therefore recommended when
using linezolid with agents such as citalopram (Celexa),
fluvoxamine (Luvox), fluoxetine (Prozac), paroxetine (Paxil), or
sertraline (Zoloft) until clinical safety is demonstrated.14,15
Source: www.aafp.org/afp/20020215/663.html
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|
Meropenem
Merrem ® | Dosing: 1 gram IV
q8h
Renal Dosing:
[CRCL >50]: no change. [26-50]: 1 gram q12h.
[10-25]: 500 mg q12h. [<10]: 500mg q24h.
Hemodialysis: 500mg q24h + 500mg after each HD. PD:
500mg q24h. |
Metronidazole
Flagyl ® | Dosing: 500 mg po/IV
q6-8h.
Renal Dosing:
[CRCL > 10]: no changes. [<10]: 500mg q8-12h
or (50% of usual dose at same interval). Hemodialysis: 500mg
q8-12h (usually q12h) or (50% of usual dose at same interval). On
dialysis days, schedule dose after dialysis. |
| Nitrofurantoin | Dosing: 50-100 mg
q6h.
Macrobid: 100 mg q12h.
Renal Dosing:
[CRCL >50]: Normal dose. [0-49]: Avoid use.
Hemo: Avoid use. |
Quinupristin/
Dalfopristin
Synercid ® | Dosing: 7.5 mg/kg
q8-12h.
Renal Dosing: No adjustment necessary. |
Rifaximin
Xifaxan ® |
Dosing (Adults): Travelers'
diarrhea: Oral: 200 mg 3 times/day for 3 days.
Supplied: 200 mg tab.
|
Tigecycline
Tygacil ® |
Glycylcycline antibiotic. Derivative of minocycline.
Dosing (Adults): Complicated
skin/skin structure or intra-abdominal infections: Initial: 100 mg
IV as a single dose. Maintenance dose: 50 mg every 12 hours.
Recommended duration of therapy:
Intra-abdominal infections or complicated skin/skin structure infections:
5-14 days.
Renal Dosing: No adjustment necessary.
Supplied: 50 mg (Injection -
powder for reconstitution)
|
Telithromycin
Ketek ® | Ketolide
antibiotic. Dosing (Adults):
Acute exacerbation of chronic bronchitis,
acute bacterial sinusitis: 800 mg orally once daily for 5 days.
Community-acquired pneumonia: 800 orally mg
once daily for 7-10 days. Renal Dosing:
crcl <30 mL/minute: 600 mg once
daily. When renal impairment is accompanied by hepatic impairment, reduce
dosage to 400 mg once daily. Hemodialysis: Administer
dose following dialysis.
Supplied: 300 mg, 400mg tab.
|
Tinidazole
Tindamax ® | Antiprotozoal.
Dosing (Adults):
Amebiasis, intestinal: Oral: 2 g/day for 3
days. Amebiasis, liver abscess: Oral: 2 g/day for
3-5 days. Giardiasis: Oral: 2 g as a single dose. Trichomoniasis: Oral: 2 g as a single dose;
sexual partners should be treated at the same time.
Renal Dosing:
no adjustment necessary.
Supplied: 250 mg, 500 mg
tab. |
| Sulfa
Allergy |
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