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Macrolides
Azithromycin (Zithromax ®) |
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Dosing (Adults): Usual oral dose: 500mg x 1, then 250mg po qd x 4 days. Chlamydia: 1 gram po x 1. MAC prevention: 1200mg once a week. Uncomplicated gonococcal infection: 2 grams po x 1. CAP: 500mg IV qd x 2 days or more then 500mg po qd. PID: 500mg IV x 1-2days, then 250mg (IV/PO) for total of 7 days.
Mild to moderate respiratory tract, skin, and soft tissue infections: 500 mg orally in a single loading dose on day 1 followed by 250 mg/day as a single dose on days 2-5. Alternative regimen: Bacterial exacerbation of COPD: 500 mg/day for a total of 3 days Bacterial sinusitis: 500 mg orally once daily x 3 days. Extended release suspension (Zmax): 2 grams x 1. Community-acquired pneumonia: Oral (Zmax™): 2 g as a single dose. I.V.: 500 mg IV qd at least 2 days, then 500 mg orally ( to complete a 7 to 10 day course of therapy). Urethritis/cervicitis: Due to C. trachomatis: 1 gram orally x 1. Due to N. gonorrhoeae: 2 grams orally x 1. Chancroid due to H. ducreyi: 1 gram orally x 1. Pelvic inflammatory disease (PID): 500 mg IV qd x 1-2 days, then 250 mg orally once daily to complete a 7 day course of therapy. Disseminated MAC disease in patient with advanced HIV infection: Prophylaxis: 1200 mg orally once weekly (may be combined with rifabutin). Treatment: 600 mg orally once daily in combination with ethambutol 15 mg/kg. Endocarditis, prophylaxis (unlabeled use): Oral: 500 mg 1 hour prior to the procedure Pertussis (CDC guidelines): Oral: 500 mg on day 1 followed by 250 mg/day on days 2-5 (maximum: 500 mg/day) Renal Dosing: No adjustments required in renal failure. Hemodialysis: No adjustments required in renal failure. Supplied: Tablet: 250 mg, 500 mg, 600 mg. Zithromax® TRI-PAK - 500 mg (Unit dose package: 3 tabs) Zithromax® Z-PAK - 250 mg (Unit dose package: 6 tabs) Oral Suspension: 100 mg/5 ml (15 ml); 200 mg/5 ml (15 ml, 22.5 ml, 30 ml) ; 1 gram - single dose packet. Zmax: 2 gram single-dose bottle (extended release formulation). Injection (powder for reconstitution): 500mg vial. |
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Clarithromycin (Biaxin ® ) |
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Dosing (Adults): Usual dosage range: Oral: 250-500 mg every 12 hours or 1000 mg (two 500 mg extended release tablets) once daily for 7-14 days. Acute exacerbation of chronic bronchitis: Oral: M. catarrhalis and S. pneumoniae: 250 mg every 12 hours for 7-14 days or 1000 mg (two 500 mg extended release tablets) once daily for 7 days. H. influenzae: 500 mg every 12 hours for 7-14 days or 1000 mg (two 500 mg extended release tablets) for 7 days. H. parainfluenzae: 500 mg every 12 hours for 7 days or 1000 mg (two 500 mg extended release tablets) for 7 days. Acute maxillary sinusitis: Oral: 500 mg every 12 hours or 1000 mg (two 500 mg extended release tablets) once daily for 14 days. Endocarditis, prophylaxis: Oral: 500 mg 1 hour prior to procedure Mycobacterial infection (prevention and treatment): Oral: 500 mg twice daily (use with other antimycobacterial drugs, eg, ethambutol or rifampin) Peptic ulcer disease: Eradication of Helicobacter pylori: Oral: Dual or triple combination regimen with bismuth subsalicylate, tetracycline, clarithromycin, and an H2-receptor; or combination of omeprazole and clarithromycin; 500 mg every 8-12 hours for 10-14 days. Pertussis (CDC guidelines): Oral: 500 mg twice daily for 7 days Pharyngitis, tonsillitis: Oral: 250 mg every 12 hours for 10 days. Pneumonia: Oral: C. pneumoniae, M. pneumoniae, and S. pneumoniae: 250 mg every 12 hours for 7-14 days or 1000 mg (two 500 mg extended release tablets) once daily for 7 days. H. influenzae: 250 mg every 12 hours for 7 days or 1000 mg (two 500 mg extended release tablets) once daily for 7 days. Skin and skin structure infection, uncomplicated: Oral: 250 mg every 12 hours for 7-14 days. Renal Dosing: [CRCL >30 ]: No changes. [<30 ]: Half the normal dose or double the dosing interval. Hemodialysis: 250 mg q12-24 hours. Schedule dose after HD on dialysis days. Supplied: Granules for oral suspension: Biaxin®: 125 mg/5 mL, 250 mg/5 mL Tablet: 250 mg, 500 mg Biaxin®: 250 mg, 500 mg Tablet, extended release: Biaxin® XL: 500 mg ADMINISTRATION — Clarithromycin may be given with or without meals. Give every 12 hours rather than twice daily to avoid peak and trough variation. Biaxin® XL: Should be given with food. Do not crush or chew extended release tablet. |
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Erythromycin |
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Dosing (Adults): (Oral): 500mg to 1g po q12h or 250mg to 1gm q6h. (IV ): 250mg to 1 gm q6h. Max 4 grams/day. Renal Dosing: [>10 ml/min]: No change. [<10 ] 50-75% of usual dose at same interval. Max 2 grams/day. [Hemo]: 50-75% of usual dose at same interval. Max 2 grams/day. No supplement. |
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Listed dosages are for - Adult patients ONLY. PLEASE READ THE
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any diagnosis or treatment made in reliance thereon. David F. McAuley, Pharm.D., R.Ph. GlobalRPh Inc. |
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