ANTIBIOTIC CHART



PRICING INFO


References:
First generation Second generation Third generation Fourth generation
Medication Dosage Form Dosing Other
Cefadroxil

(Duricef®)
Capsule
  • 500 mg ($)

Tablet
  • 1000 mg ($-$$)

Suspension
  • 250 mg/5 ml
  • 500 mg/5 ml ($-$$)
Pediatric
  • Impetigo - 30 mg/kg/day (max 1000 mg/day) given once daily or divided into 2 doses (PI)
  • Skin infections - 30 mg/kg/day (max 1000 mg/day) given in 2 divided doses (PI)
  • Strep throat - 30 mg/kg once daily (max 1000 mg/day) for 10 days (IDSA)
  • Urinary tract infection - 30 mg/kg/day (max 1000 mg/day) given in 2 divided doses (PI)

Adults
  • Skin infections - 1000 mg/day given once daily or divided into 2 doses (PI)
  • Strep throat - 1000 mg/day given once daily or divided into 2 doses for 10 days (IDSA)
  • Urinary tract infection - 1000 - 2000 mg/day given once daily or divided into 2 doses for 3 - 7 days (IDSA, PI)
  • Cefadroxil is a first generation cephalosporin
  • May take without regard to food
  • Kidney disease (adults)
    • CrCl < 50 ml/min: dose adjustment recommended; see cefadroxil PI
Cephalexin

(Keflex®)
Capsule
  • 250 mg ($)
  • 500 mg ($)
  • 750 mg ($$$$)

Tablet
  • 250 mg
  • 500 mg ($)

Suspension
  • 125 mg/5 ml
  • 250 mg/5 ml ($)
Pediatric
  • Cellulitis (non-MRSA) - 25 - 50 mg/kg/day (max 2000 mg/day) given in 4 divided doses for 5 - 10 days (IDSA)
  • Endocarditis prophylaxis - 50 mg/kg (max 2000 mg) 30 - 60 minutes before procedure (penicillin allergic without severe reaction) (AHA)
  • Impetigo - 25 – 50 mg/kg/day (max 1000 mg/day) given in 3 – 4 divided doses for 7 days (IDSA)
  • Otitis media - 75 - 100 mg/kg/day given in 4 divided doses for 5 - 10 days (PI)
  • Strep throat - 40 mg/kg/day (max 1000 mg/day) given in 2 divided doses for 10 days (IDSA)
  • Urinary tract infection - 50 - 100 mg/kg/day (max 2000 mg/day) given in 4 divided doses for 7 - 14 days (CTE)

Adults (15 years and older)
  • Cephalexin is a first generation cephalosporin
  • May take without regard to food
  • Cephalexin is a first generation cephalosporin
  • Cephalexin may increase metformin levels
  • Kidney disease - clearance is reduced. Manufacturer makes no specific recommendation.
Cefaclor

(Ceclor®)
Capsule
  • 250 mg ($)
  • 500 mg ($)

Suspension
  • 125 mg/5 ml ($)
  • 250 mg/5 ml ($$-$$$)
  • 375 mg/5 ml ($$-$$$)
Pediatric
Adults
  • Cefaclor is a second generation cephalosporin
  • Food slows absorption but does not affect the extent of absorption
  • Liver disease - manufacturer makes no dosage recommendation
  • Kidney disease - no dose adjustment necessary
Cefprozil

(Cefzil®)
Tablet
  • 250 mg
  • 500 mg ($)

Suspension
  • 125 mg/5 ml
  • 250 mg/5 ml ($-$$)
Pediatric (6 months - 12 years)
  • Cellulitis - 20 mg/kg/day (max 1000 mg/day) given once daily for 10 days (PI)
  • Otitis media - 30 mg/kg/day (max 1000 mg/day) given in 2 divided doses for 10 days (PI)
  • Pneumonia, community-acquired - 30 mg/kg/day (max 1000 mg/day) given in 2 divided doses for 7 - 10 days (IDSA)
  • Sinusitis - 15 - 30 mg/kg/day (max 1000 mg/day) given in 2 divided doses for 10 days (PI)
  • Strep throat - 15 mg/kg/day (max 500 mg/day) given in 2 divided doses for 10 days (PI)

Adolescents and Adults (age 12 years and older)
  • Cellulitis - 250 - 500 mg twice a day or 500 mg once daily for 10 days (PI)
  • Sinusitis - 250 - 500 mg twice a day for 10 days (PI)
  • Strep throat - 500 mg once daily for 10 days (PI)
  • Cefprozil is a second generation cephalosporin
  • May take without regard to food
  • Liver disease - no dose adjustment necessary
  • Kidney disease
    • CrCl ≤ 29 ml/min: - use half the standard dose
Cefuroxime

(Ceftin®)
Tablet
  • 125 mg
  • 250 mg
  • 500 mg ($)

Suspension
  • 125 mg/5 ml
  • 250 mg/5 ml ($$-$$$)
Pediatric (3 months to 12 years)
NOTE: Pediatric dosing is for suspension only. Suspension and tablet are not bioequivalent on a mg-to-mg basis.

  • Impetigo - 30 mg/kg/day (max 1000 mg/day) given in 2 divided doses for 10 days (PI)
  • Otitis media - 30 mg/kg/day (max 1000 mg/day) given in 2 divided doses for 5 - 10 days (AAP)
  • Pneumonia, community-acquired - 30 mg/kg/day (max 1000 mg/day) given in 2 divided doses for 7 - 10 days (IDSA)
  • Sinusitis - 30 mg/kg/day (max 1000 mg/day) given in 2 divided doses for a minimum of 10 days (AAP)
  • Strep throat - 20 mg/kg/day (max 500 mg/day) given in 2 divided doses for 10 days (PI)
  • Urinary tract infection - 20 - 30 mg/kg/day (max 1000 mg/day) given in 2 divided doses for 7 - 14 days (CTE)

Adolescents and Adults (13 years and older)
  • Cefuroxime is a second generation cephalosporin
  • Suspension should be taken with food
  • Tablets may be taken without regard to food
  • Tablets and suspension are not substitutable on a mg-to-mg basis
  • Kidney disease
    • CrCl ≥ 30 ml/min - no adjustment necessary
    • CrCl 10 - 29 ml/min - give standard individual dose every 24 hours
    • CrCl < 10 ml/min - give standard individual dose every 48 hours
Cefdinir

(Omnicef®)
Capsule
  • 300 mg ($)

Suspension
  • 125 mg/5 ml
  • 250 mg/5 ml ($)
Pediatric (6 months - 12 years)
  • Otitis media - 14 mg/kg/day (max 600 mg/day) given in 1 or 2 divided doses for 5 - 10 days (AAP)
  • Sinusitis - 14 mg/kg/day (max 600 mg/day) given in 1 or 2 divided doses for a minimum of 10 days (AAP)
  • Skin infections - 7 mg/kg/dose (max 300 mg/dose) twice a day for 10 days (PI)
  • Strep throat - 7 mg/kg/dose (max 300 mg/dose) twice a day for 5 to 10 days OR 14 mg/kg (max 600 mg/day) once daily for 10 days (PI)

Adults and Adolescents (Age 13 years and older)
  • Cefdinir is a third generation cephalosporin
  • May take without regard to food
  • Iron supplements and antacids reduce cefdinir absorption. Do not take within 2 hours of each other.
  • Cefdinir and iron may cause stool to turn red
  • Liver disease - no dose adjustment necessary
  • Kidney disease
    • CrCl < 30 ml/min: adult dose is 300 mg once daily; pediatric dose is 7 mg/kg/day (max 300 mg/day) given once daily
Cefditoren

(Spectracef®)
Tablet
  • 200 mg ($$$$)
  • 400 mg ($$$$)
Adults and Adolescents (Age 12 years and older)
  • Cefditoren has been discontinued in the U.S.
  • Cefditoren is a third generation cephalosporin
  • Take with a meal to increase absorption
  • Drugs that reduce gastric acidity (e.g. antacids, H2 blockers, PPIs) decrease absorption
  • Liver disease
    • Child-Pugh A/B: no dose adjustment necessary
    • Child-Pugh C: has not been studied
  • Kidney disease
    • CrCl > 50 ml/min: No dose adjustment necessary
    • CrCl 30 - 49 ml/min: 200 mg twice a day
    • CrCl < 30 ml/min: 200 mg once daily
Cefixime

(Suprax®)
Capsule
  • 400 mg ($$$$)

Tablet, chewable
  • 100 mg
  • 150 mg
  • 200 mg ($$$$)

Tablet
  • 400 mg ($$$$)

Suspension
  • 100 mg/5 ml
  • 200 mg/5 ml
  • 500 mg/5 ml ($$$$)
Pediatric (6 months - 12 years)
Adults and Adolescents (Age 12 years and older)
  • Cefixime is a third generation cephalosporin
  • May take without regard to food
  • Kidney disease
    • CrCl < 60 ml/min: dose adjustment recommended; see cefixime PI for details
Cefpodoxime

(Vantin®)
Tablet
  • 100 mg
  • 200 mg ($$-$$$)

Suspension
  • 50 mg/5 ml
  • 100 mg/5 ml ($$-$$$)
Pediatric (age 2 months through 12 years)
  • Otitis media - 10 mg/kg/day (max 400 mg/day) given in 2 divided doses for 5 - 10 days (AAP)
  • Pneumonia, community-acquired - 10 mg/kg/day (max 400 mg/day) given in 2 divided doses for 7 - 10 days (IDSA)
  • Sinusitis - 10 mg/kg/day (max 400 mg/day) given in 2 divided doses for a minimum of 10 days (AAP)
  • Strep throat - 10 mg/kg/day (max 200 mg/day) given in 2 divided doses for 5 - 10 days (PI)
  • Urinary tract infection - 10 mg/kg/day (max 400 mg/day) given in 2 divided doses for 7 - 14 days (CTE)

Adolescents and Adults (age 12 years and older)
  • Cefpodoxime is a third generation cephalosporin
  • Suspension may be taken without regard to food
  • Tablets should be taken with food
  • Drugs that reduce gastric acidity (e.g. antacids, H2 blockers, PPIs) decrease absorption
  • Liver disease - no dose adjustment necessary
  • Kidney disease
    • CrCl < 30 ml/min: increase dosing interval to every 24 hours
Ceftibuten

(Cedax®)
Capsule
  • 400 mg ($$$-$$$$)

Suspension
  • 180 mg/5 ml ($$$$)
Pediatric
  • Otitis media - 9 mg/kg/day (max 400 mg/day) given once daily for 10 days (PI)
  • Strep throat - 9 mg/kg/day (max 400 mg/day) given once daily for 10 days (PI)

Adolescents and Adults (age 12 years and older)
  • Ceftibuten has been discontinued in the U.S.
  • Ceftibuten is a third generation cephalosporin
  • Ceftibuten should be taken at least 2 hours before or one hour after a meal. Food decreases absorption.
  • Liver disease - manufacturer makes no dosage recommendation
  • Kidney disease
      • CrCl > 50 ml/min: No dose adjustment necessary
      • CrCl 30 - 49 ml/min: 4.5 mg/kg/day or 200 mg once daily
      • CrCl 5 - 29 ml/min: 2.25 mg/kg/day or 100 mg once daily
Ceftriaxone

(Rocephin®)
Vial
  • 250 mg
  • 500 mg
  • 1000 mg
  • 2000 mg ($)
Pediatric
Adult
  • Ceftriaxone is a third generation cephalosporin
  • Do not give to neonates ≤ 28 days old with hyperbilirubinemia
  • Liver disease - no dose adjustment necessary
  • Kidney disease - no dose adjustment necessary
  • Kidney and liver disease (concurrent) - do not exceed 2 grams daily

Medication Dosage Form Dosing Other
Clindamycin

(Cleocin®)
Capsule
  • 75 mg
  • 150 mg
  • 300 mg ($)

Solution
  • 75 mg/5 ml ($$)

Vaginal cream
  • 2%, 40 gm tube ($-$$)

Vaginal suppository
  • 100 mg ($$$)

Topical
Pediatric
  • Cellulitis (MRSA coverage) - 30 - 40 mg/kg/day (max 1800 mg/day) given in 3 divided doses for 5 - 10 days (IDSA)
  • Endocarditis prophylaxis - 20 mg/kg (max 600 mg) 30 - 60 minutes before procedure (penicillin allergic) (AHA)
  • Impetigo - 20 mg/kg/day (max 1600 mg/day) given in 3 divided doses for 7 days (IDSA)
  • Otitis media - 30 – 40 mg/kg/day (max 1800 mg/day) given in 3 divided doses for 5 - 10 days (AAP)
  • Sinusitis - 8 - 12 mg/kg/day divided into 3 or 4 equal doses for a minimum of 10 days. Give with Cefixime (Suprax®). See AAP sinusitis recs. (AAP, PI)
  • Strep throat - 7 mg/kg/dose (max 300 mg/dose) three times daily for 10 days (IDSA)

Adults
  • May take without regard to food
  • Liver disease - dose adjustment not likely necessary
  • Kidney disease - no dose adjustment necessary

Medication Dosage Form Dosing Other
Fosfomycin

(Monurol®)
Powder
  • 3 gram packet ($$)
Adults
  • May take without regard to food
  • Mix packet with 3 - 4 ounces of water
  • Kidney disease - clearance is decreased. Manufacturer makes no specific recommendation.

Medication Dosage Form Dosing Other/Recent studies
Azithromycin

(Zithromax®)
Tablet
  • 250 mg
  • 500 mg
  • 600 mg ($)

Suspension
  • 100 mg/5 ml
  • 200 mg/5 ml ($)

Packet of powder
  • 1000 mg ($-$$)

Suspension, extended-release (Zmax®)
  • 2 grams/bottle ($$$)

Ophthalmic
Pediatric (6 months to 12 years)
  • Campylobacter - 10 mg/kg/day (max 500 mg/day) given once daily for 3 - 5 days (CTE)
  • Cat scratch disease
    • < 45 kg - 10 mg/kg (max 500 mg) on Day 1 followed by 5 mg/kg/day (max 250 mg/day) on Days 2 - 5
    • > 45 kg - 500 mg on Day 1 followed by 250 mg once daily on Days 2 - 5 (IDSA)
  • E. coli, enterotoxigenic - 10 mg/kg/day (max 500 mg/day) given once daily for 3 days (CTE)
  • Endocarditis prophylaxis -15 mg/kg (max 500 mg) 30 - 60 minutes before procedure (penicillin allergic) (AHA)
  • Pneumonia, community-acquired, atypical - 10 mg/kg (max 500 mg) on Day 1 followed by 5 mg/kg/day (max 250 mg/day) given once daily on Days 2 - 5 (IDSA)
  • Salmonella (nontyphoidal) - 20 mg/kg/day (max 500 mg/day) given once daily for 7 days (CTE)
  • Shigella - 10 mg/kg/day (max 500 mg/day) given once daily for 3 days (CTE)
  • Strep throat - 12 mg/kg/day (max 500 mg/day) given once daily for 5 days (IDSA)
  • Vibrio vulnificus - 10 mg/kg/day (max 500 mg/day) given once daily for 3 days (CTE)

Adolescents and Adults
Other
  • May take without regard to food
  • Do not take with aluminum or magnesium antacids
  • Kidney disease
    • CrCl > 10 ml/min: no dose adjustment necessary
    • CrCl < 10 ml/min: use caution

Recent studies
  • Macrolide use in pregnancy and risk of birth defects [PMID 26513406]
Clarithromycin

(Biaxin®)
Tablet
  • 250 mg
  • 500 mg ($)

Tablet, extended-release
(Biaxin XL®)
  • 500mg ($-$$)

Suspension
  • 125 mg/5 ml
  • 250 mg/5 ml ($$)
Pediatric
Adults
Other
  • Standard-release tablet and suspension may be taken without regard to food. Extended-release tablets should be taken with food.
  • Clarithromycin is a Strong CYP3A4 inhibitor
  • Liver disease - no dose adjustment necessary
  • Kidney disease
    • CrCl < 30 ml/min: - reduce dose by 50%

Recent studies
  • Macrolide use in pregnancy and risk of birth defects [PMID 26513406]
Erythromycin

(Eryc®)
(E.E.S.®)
(Eryped®)

Erythromycin base


Capsule, enteric coated (Eryc®)
  • 250 mg ($$-$$$)

Tablet, enteric coated (Ery-tab®)
  • 250 mg
  • 333 mg
  • 500 mg ($$$-$$$$)

Tablet, enteric coated (PCE®)
  • 333 mg
  • 500 mg ($$-$$$)

Tablet
  • 250 mg
  • 500 mg ($$-$$$$)

Ophthalmic
Topical

Erythromycin Ethylsuccinate


Tablet (E.E.S.®)
  • 400 mg ($$$-$$$$)

Granule (E.E.S.®, Eryped®)
  • 200 mg/5 ml
  • 400 mg/5 ml ($$$$)

Suspension (E.E.S.®, Pediamycin®)
  • 200 mg/5 ml
  • 400 mg/5 ml ($$$$)

Erythromycin Stearate


Tablet
  • 250 mg
Pediatric
  • Campylobacter
    • Erythromycin base - 30 mg/kg/day given in 2 - 4 divided doses for 3 - 5 days (CTE)
  • Impetigo
    • Erythromycin ethylsuccinate - 40 mg/kg/day (max 1600 mg/day) given in 3 – 4 divided doses for 7 days (IDSA)
  • Pneumonia, community-acquired, atypical
    • Erythromycin ethylsuccinate - 40 mg/kg/day (max 1600 mg/day) given in 4 divided doses for 7 - 10 days (IDSA)

Adolescents and adults
  • Acne
    • Erythromycin base - 250 - 500 mg once daily or 250 - 500mg twice a day (AAP)
  • Campylobacter
    • Erythromycin base - 500 mg two to four times a day for 3 - 5 days (IDSA/CTE)
  • Chlamydia
    • Erythromycin base - 500 mg four times a day for 7 days (CDC)
    • Erythromycin ethylsuccinate - 800 mg four times a day for 7 days (CDC)
  • Impetigo
    • Erythromycin base - 250 mg four times a day for 7 days (IDSA)
    • Erythromycin ethylsuccinate - 400 mg four times a day for 7 days (IDSA)
  • Pneumonia, community-acquired
    • Erythromycin base - 500 mg four times a day or 1000 mg twice a day for 7 - 14 days (IDSA, CTE) [2]
    • Erythromycin ethylsuccinate - 800 mg four times a day or 1600 mg twice a day for 7 - 14 days
Other
  • May take without regard to food
  • 400 mg of erythromycin ethylsuccinate is equivalent to 250 mg of erythromycin base or stearate
  • Erythromycin is a Moderate CYP3A4 inhibitor
  • Liver disease - use caution. Manufacturer makes no specific recommendation.
  • Kidney disease - erythromycin is mostly excreted in the bile. Manufacturer makes no specific recommendation.

Recent studies
  • Macrolide use in pregnancy and risk of birth defects [PMID 26513406]

Medication Dosage Form Dosing Other
Nitrofurantoin

(Macrobid®)
(Macrodantin®)
(Furadantin®)

Nitrofurantoin monohydrate :
Nitrofurantoin macrocrystalline


Capsule, Macrobid®
  • 75 mg : 25 mg ($)

Nitrofurantoin macrocrystalline


Capsule, Macrodantin®
  • 25 mg
  • 50 mg
  • 100 mg ($)

Nitrofurantoin


Suspension, Furadantin®
  • 25 mg/5 ml ($$$$)
Pediatric (one month and older)
Adults
  • Urinary tract infection
    • Macrobid® - 100 mg twice a day for 5 days (IDSA)
    • Macrodantin® - 50 - 100 mg 4 times a day for 7 days (PI)
  • Urinary tract infection, prophylaxis
    • Postcoital - 50 - 100 mg one time postcoital (Macrobid® or Macrodantin®) (CTE)
    • Continuous - 50 - 100 mg once daily (Macrobid® or Macrodantin®) (CTE)
  • Take with food
  • Do not take with antacids containing magnesium
  • Nitrofurantoin has been associated with rare cases of interstitial lung disease in patients who took it for ≥ 6 months
  • Kidney disease
    • CrCl < 60 ml/min: - do not use

Medication Dosage Form Dosing Other
Metronidazole

(Flagyl®)
Capsule
  • 375 mg ($$)

Tablet
  • 250 mg
  • 500 mg ($)

Tablet, extended-release
(Flagyl® ER)
  • 750 mg ($$$$)

Topical
Pediatric
Adults
  • May take standard-release without regard to food. Extended-release should be taken one hour before or 2 hours after meals.
  • Potential for disulfiram-like reaction if taken with alcohol. Do not ingest alcohol during, or for 3 days after stopping metronidazole.
  • Liver disease
    • Mild to moderate (Child-Pugh A/B): no dose adjustment necessary
    • Severe (Child-Pugh C): reduce dose by 50%
  • Kidney disease - patients with end-stage renal disease may have decreased clearance. Manufacturer makes no specific recommendation.
Tinidazole

(Tindamax®)
Tablet
  • 250 mg
  • 500 mg ($-$$)
Pediatric (3 years and older)
  • Entamoeba histolytica - 50 mg/kg/day (max 2000 mg/day) given once daily for 3 days (PI)
  • Giardia - 50 mg/kg (max 2000 mg) given as a one time dose (PI)

Adults
  • Take with food to minimize stomach upset
  • Tinidazole is a CYP3A4 sensitive substrate
  • Potential for disulfiram-like reaction if taken with alcohol. Do not ingest alcohol during, or for 3 days after stopping tinidazole.
  • Liver disease - use caution. Manufacturer makes no specific recommendation.
  • Kidney disease - no dose adjustment necessary

Medication Dosage Form Dosing Other/Recent studies
Linezolid

(Zyvox®)
Tablet
  • 600 mg ($$$$)

Suspension
  • 100 mg/5 ml ($$$$)
Pediatric
  • Cellulitis (MRSA coverage)
    • < 5 years old - 10 mg/kg/dose every 8 hours for 5 - 10 days (IDSA, PI)
    • 5 - 11 years old - 10 mg/kg/dose (max 600 mg/dose) twice a day for 5 - 10 days (IDSA, PI)
  • Pneumonia, community-acquired
    • < 12 years old - 30 mg/kg/day given in 3 divided doses for 7 - 10 days (IDSA)
    • ≥ 12 years old - 20 mg/kg/day (max 1200 mg/day) given in 2 divided doses for 7 - 10 days (IDSA)

Adults (12 years and older)
Other
  • May take without regard to food
  • Linezolid is a reversible, nonselective MAO inhibitor
  • Do not take within 2 weeks of other MAO inhibitors
  • May increase pressor effect of adrenergic agents including pseudoephedrine and phenylpropanolamine. Foods containing tyramine should also be avoided in large quantities (e.g. aged cheeses, fermented or air-dried meats, sauerkraut, soy sauce, tap beers, and red wines)
  • Has been associated with serotonin syndrome. Use caution when taken with antidepressants and other serotonergic drugs.
  • Liver disease
    • Mild to moderate (Child-Pugh A/B): no dose adjustment necessary
    • Severe (Child-Pugh C): has not been evaluated
  • Kidney disease - no dose adjustment necessary

Studies
  • Linezolid susceptibility testing 2014 - 6,865 Gram-positive pathogens from 36 states collected in 2014 were tested for susceptibility to linezolid
    RESULTS: Linezolid demonstrated excellent activity and a sustained susceptibility rate of 99.78% overall [PMID 26833165]

Medication Dosage Form Dosing Other
Amoxicillin

(Amoxil®)
Capsule
  • 250 mg
  • 500 mg ($)

Tablet
  • 500 mg
  • 875 mg ($)

Tablet, chewable
  • 125 mg
  • 250 mg ($)

Tablet, extended-release (Moxatag®)
  • 775 mg ($$$)

Suspension
  • 125 mg/5 ml
  • 200 mg/5 ml
  • 250 mg/5 ml
  • 400 mg/5 ml ($)
Pediatric
  • Endocarditis prophylaxis - 50 mg/kg (max 2000 mg) 30 - 60 minutes before procedure (AHA)
  • H. pylori - Amoxicillin - 50 mg/kg/day (max 2000 mg/day) given in 2 divided doses +
  • H. pylori, sequential therapy - see H. pylori treatment
  • Otitis media - 80 - 90 mg/kg/day given in 2 divided doses for 5 - 10 days (AAP)
  • Pneumonia, community-acquired - 90 mg/kg/day (max 4000 mg/day) given in 2 divided doses for 7 - 10 days (IDSA)
  • Sinusitis
    • Standard therapy - 45 mg/kg/day given in 2 divided doses for a minimum of 10 days (AAP)
    • High-dose therapy - 80 to 90 mg/kg/day (max 4000 mg/day) given in 2 divided doses for a minimum of 10 days (AAP)
  • Strep throat - 50 mg/kg/day (max 1000 mg/day) given once daily or in 2 divided doses for 10 days (IDSA)

Adults
  • May take without regard to food
  • Kidney disease
    • CrCl 10 - 30 ml/min: 250 - 500 mg every 12 hours
    • CrCl < 10 ml/min: 250 - 500 mg every 24 hours
Amoxicillin-
clavulanate

(Augmentin®)
Tablet (amoxil : clav)
  • 250 mg : 125 mg ($$)
  • 500 mg : 125 mg ($)
  • 875 mg : 125 mg ($)

Tablet, chewable (amoxil : clav)
  • 7:1 ratio
    • 200 mg : 28.5 mg
    • 400 mg : 57 mg ($)

Tablet, extended-release
(Augmentin XR®)
  • 1000 mg : 62.5 mg ($$)

Suspension (amoxil:clav)
  • 4:1 ratio
    • 125 mg : 31.25 mg/5 ml
    • 250 mg : 62.5 mg/5 ml ($)
  • 7:1 ratio
    • 200 mg : 28.5 mg/5 ml
    • 400 mg : 57 mg/5 ml ($)
  • 14:1 ratio (Augmentin ES®)
    • 600 mg : 42.9 mg/5 ml ($)
Pediatric
  • Impetigo - 25 mg/kg/day (max 1750 mg/day) of the amoxicillin component given in 2 divided doses for 7 days (IDSA)
  • Otitis media - 90 mg/kg/day of amoxicillin, with 6.4 mg/kg/day of clavulanate [amoxicillin to clavulanate ratio, 14:1] (max 4000 mg/day) in 2 divided doses for 5 - 10 days (AAP)
  • Pneumonia, community-acquired - 90 mg/kg/day (max 4000 mg/day) given in 2 divided doses for 7 - 10 days (IDSA)
  • Sinusitis - 80 – 90 mg/kg/day of the amoxicillin component with 6.4 mg/kg/day of clavulanate [amoxicillin to clavulanate ratio, 14:1] in 2 divided doses (max 4000 mg/day) for a minimum of 10 days (AAP)
  • Urinary tract infection - 20 - 40 mg/kg/day given in 3 divided doses for 7 - 14 days (CTE)

Adults
  • May take without regard to meals, although taking with food may help reduce gastrointestinal upset
  • Amoxicillin-clavulanate preparations with a 14:1 ratio of amoxicillin-clavulanate may be less likely to cause diarrhea than preparations with a lower ratio
  • Kidney disease
    • Standard tablet and suspension
      • CrCl < 30 ml/min: do not give 875 mg dose
      • CrCl 10 - 30 ml/min: 250 - 500 mg every 12 hours
      • CrCl < 10 ml/min: 250 - 500 mg every 24 hours
Dicloxacillin
Capsule
  • 250 mg
  • 500 mg ($)
Pediatric
  • Cellulitis (non-MRSA) - 25 - 50 mg/kg/day (max 2000 mg/day) given in 4 divided doses for 5 - 10 days (IDSA)

Adults
  • Should be taken on an empty stomach at least 1 hour before and 2 hours after a meal
  • Kidney disease - dose reduction recommended. Manufacturer makes no specific recommendation.
Penicillin G
benzathine

(Bicillin L-A®)
Disposable syringe
  • 1 ml - 600,000 units ($$)
  • 2 ml - 1,200,000 units ($$$)
  • 4 ml - 2,400,000 units ($$$$)
Pediatric
  • Strep throat
    • < 27 kg - 600,000 units IM single dose (IDSA)
    • ≥ 27 kg - 1,200,000 units IM single dose (IDSA)
  • Impetigo
    • ≤ 6 kg - 225 mg (300,000 units) IM given as a one time dose
    • 6.1 - 10 kg - 337.5 mg (450,000 units) IM given as a one time dose
    • 10.1 - 15 kg - 450 mg (600,000 units) IM given as a one time dose
    • 15.1 - 20 kg - 675 mg (900,000 units) IM given as a one time dose
    • > 20 kg - 900 mg (1,200,000 units) IM given as a one time dose

Adults
  • Strep throat - 1,200,000 units IM single dose
  • Syphilis
    • Primary and secondary - 2.4 million units IM single dose (CDC)
    • Early latent - 2.4 million units IM single dose (CDC)
    • Latent - 2.4 million units IM once a week for a total of 3 doses (CDC)
    • Tertiary - 2.4 million units IM once a week for a total of 3 doses (CDC)
  • For IM use only
  • Kidney disease - clearance is decreased. Manufacturer makes no specific recommendation.

    • Milligram-unit conversion
      • 225 mg = 300,000 units
      • 337.5 mg = 450,000 units
      • 450 mg = 600,000 units
      • 675 mg = 900,000 units
      • 900 mg = 1,200,000 units
Penicillin

(Pen VK®)
Tablet
  • 250 mg
  • 500 mg ($)

Solution
  • 125 mg/5 ml
  • 250 mg/5 ml ($)
Pediatric
  • Strep throat - 250 mg two to three times a day for 10 days (IDSA)

Adults
  • May take without regard to meals
  • Kidney disease - drug clearance is decreased. Manufacturer makes no specific dosage recommendation.

Medication Dosage Form Dosing Other
Ciprofloxacin

(Cipro®)
Suspension
  • 250 mg/5 ml ($$-$$$)
  • 500 mg/5 ml ($$-$$$)

Tablet
  • 100 mg
  • 250 mg
  • 500 mg
  • 750 mg ($)

Tablet, extended-release
  • 500 mg
  • 1000 mg ($-$$)

Ophthalmic
Otic
Pediatric (≥ 1 year old)
Adults
  • May take without regard to food
  • Do not take with tizanidine (Zanaflex®)
  • Take 2 hours before or 6 hours after magnesium or aluminum antacids
  • Ciprofloxacin is a Strong CYP1A2 inhibitor
  • May cause photosensitivity. Limit sun exposure, use sunscreen.
  • Liver disease - in studies involving patients with chronic cirrhosis, no significant changes in ciprofloxacin pharmacokinetics were observed. The effects of acute hepatic insufficiency on ciprofloxacin are unknown.
  • Kidney disease
    • Standard-release
      • CrCl > 50 ml/min: no dose adjustment necessary
      • CrCl 30 - 50 ml/min: 250 - 500 mg every 12 hours
      • CrCl 5 - 29 ml/min: 250 - 500 mg every 18 hours
    • Extended-release
      • CrCl ≤ 30 ml/min: - 500 mg once daily
Gemifloxacin

(Factive®)
Tablet
  • 320 mg ($$$$)
Adults
  • May take without regard to food
  • Antacids, sucralfate, metal cations (e.g. iron), and multivitamins may reduce gemifloxacin absorption. Gemifloxacin should be taken 3 hours before or 2 hours after these medications.
  • Liver disease - no dose adjustment necessary
  • Kidney disease
    • CrCl ≤ 40 ml/min: 160 mg every 24 hours
Levofloxacin

(Levaquin®)
Tablet
  • 250 mg
  • 500 mg
  • 750 mg ($)

Solution
  • 25 mg/ml ($$)

Ophthalmic
Pediatric
  • Pneumonia, community-acquired
    • 6 months - 5 years old - 16 - 20 mg/kg/day given in 2 divided doses for 7 - 10 days (IDSA)
    • 5 - 16 years old - 8 - 10 mg/kg/day (max 750 mg/day) given once daily for 7 - 10 days (IDSA)
  • Sinusitis - 16 mg/kg/day (max 500 mg/day) given in 2 divided doses for a minimum of 10 days (AAP)

Adults
  • aDue to methicillin-susceptible Staphylococcus aureus, Streptococcus pneumoniae (including multidrug-resistant isolates [MDRSP]), Haemophilus influenzae, Haemophilus parainfluenzae, Klebsiella pneumoniae, Moraxella catarrhalis, Chlamydophila pneumoniae, Legionella pneumophila, or Mycoplasma pneumoniae
  • bDue to Streptococcus pneumoniae (excluding multi-drug-resistant isolates [MDRSP]), Haemophilus influenzae, Haemophilus parainfluenzae, Mycoplasma pneumoniae, or Chlamydophila pneumoniae
  • c due to Escherichia coli, Klebsiella pneumoniae, Proteus mirabilis and pyelonephritis due to E. coli, including cases with concurrent bacteremia
  • d Enterococcus faecalis, Enterococcus cloacae, Escherichia coli, Klebsiella pneumoniae, Proteus mirabilis, Pseudomonas aeruginosa; and for pyelonephritis due to E. coli
  • May take without regard to food
  • Antacids, sucralfate, metal cations (e.g. iron), and multivitamins may reduce levofloxacin absorption. Do not take within 2 hours of each other.
  • Quinolones have not been considered first-line agents in children because of the possible risk of adverse effects on developing cartilage. In studies, these effects appear to be uncommon. [1]
  • May cause photosensitivity. Limit sun exposure, use sunscreen.
  • Liver disease - no dose adjustment necessary
  • Kidney disease
    • CrCl ≤ 49 ml/min: dose adjustment recommended; see Levaquin® PI for more.
Moxifloxacin

(Avelox®)
Tablet
  • 400 mg ($$-$$$)

Ophthalmic
Adults
  • May take without regard to food
  • Antacids, sucralfate, metal cations (e.g. iron), and multivitamins may reduce moxifloxacin absorption. Moxifloxacin should be taken 4 hours before or 8 hours after these medications.
  • Liver disease - no dose adjustment necessary
  • Kidney disease - no dose adjustment necessary
Ofloxacin
Tablet
  • 200 mg
  • 300 mg
  • 400 mg ($$)

Ophthalmic
Otic
Adults
  • May take without regard to food
  • Antacids, sucralfate, metal cations (e.g. iron), and multivitamins may reduce ofloxacin absorption. Do not take within 2 hours of each other.
  • May cause photosensitivity. Limit sun exposure, use sunscreen.
  • Liver disease
    • Severe (Child-Pugh C): do not exceed 400 mg/day
  • Kidney disease
    • CrCl 20 - 50 ml/min: usual dose every 24 hours
    • CrCl < 20 ml/min: half the usual dose every 24 hours

Medication Dosage Form Dosing Other
Sulfamethoxazole-
trimethoprim

(Septra®)
(Bactrim®)
Tablet (sulfa/tmp)
  • 800/160 mg (double strength)
  • 400/80 mg (single strength) ($)

Suspension (sulfa/tmp)
  • 200 mg/40 mg/5 ml ($)
Pediatric (≥ 2 months old)
NOTE: All pediatric dosing based on trimethoprim component

  • Cellulitis (MRSA coverage) - 8 – 12 mg/kg/day given in 2 divided doses for 5 - 10 days (IDSA)
  • Cyclospora - 5 mg/kg/day (max 320 mg/day) given in 2 divided doses for 3 days (CTE)
  • Impetigo
    • Once daily - 8 mg/kg/day (max 320 mg/day) given once daily for 5 days
    • Twice daily - 8 mg/kg/day (max 320 mg/day) given in two divided doses for 3 days
  • Salmonella, nontyphoidal - 10 mg/kg/day (max 320 mg/day) given in 2 divided doses for 5 - 7 days (IDSA)
  • Shigella - 10 mg/kg/day (max 320 mg/day) given in 2 divided doses for 3 days (IDSA)
  • Urinary tract infection - 6 - 12 mg/kg/day (max 320 mg/day) given in 2 divided doses for 7 - 14 days (CTE)
  • Urinary tract infection, prophylaxis - 3 mg/kg/day (max 40 mg/day) given once daily (CTE)

Adolescents and adults
  • May be taken without regard to food
  • May cause photosensitivity. Limit sun exposure, use sunscreen.
  • Trimethoprim may raise potassium levels in susceptible patients
  • Trimethoprim is a CYP2C8 inhibitor
  • Trimethoprim is an OCT2 inhibitor and substrate
  • Sulfamethoxazole is a Weak CYP2C9 inhibitor
  • Liver disease - do not use in patients with significant liver disease
  • Kidney disease
    • CrCL > 30 ml/min: no dose adjustment necessary
    • CrCl 15 - 30 ml/min: use half the usual dose
    • CrCl < 15 ml/min: do not use

Medication Dosage Form Dosing Other
Doxycycline
Monohydrate and
Hyclate

(Acticlate®)
(Vibramycin®)
(Doryx®)
(Oracea®)

Monohydrate


Capsule
  • 50 mg, 100 mg ($)
  • 75 mg, 150 mg ($$$$)

Capsule (Oracea®)
  • 40 mg ($$$$)
  • Contains 30 mg immediate release and 10 mg delayed release

Tablet
  • 50 mg, 75 mg, 100 mg ($)
  • 150 mg ($$$-$$$$)

Suspension
  • 25 mg/5 ml ($-$$)

Hyclate


Capsule
  • 50 mg
  • 100 mg ($-$$)

Capsule - delayed release
  • 75 mg
  • 100 mg ($$-$$$)

Tablet
  • 20 mg ($)
  • 100 mg ($-$$)

Tablet - delayed release (Doryx®)
  • 50 mg
  • 75 mg
  • 100 mg
  • 150 mg
  • 200 mg ($$-$$$$)

Tablet (Acticlate®)
  • 75 mg
  • 150 mg ($$$$)
Pediatric (≥ 8 years old)
Adolescents and adults
  • May be taken without regard to food (except Oracea®)
  • Take with full glass of water to reduce risk of esophageal irritation
  • Dairy products do not affect doxycycline absorption
  • Concomitant use of tetracyclines and isotretinoin has been associated with pseudotumor cerebri. Concurrent use should be avoided.
  • May cause photosensitivity. Limit sun exposure, use sunscreen.
  • Antacids may decrease bioavailability of doxycycline. Do not take within 4 hours of each other.
  • Doxycycline should not be used in children < 8 years old because of possible tooth discoloration
  • Kidney disease - no dose adjustment necessary
Minocycline

(Minocin®)
(Dynacin®)
(Solodyn®)
Capsule
  • 50 mg
  • 75 mg
  • 100 mg ($)

Tablet
  • 50 mg
  • 75 mg
  • 100 mg ($$$-$$$$)

Tablet, extended-release (Solodyn®)
  • 45 mg
  • 65 mg
  • 80 mg
  • 90 mg
  • 105 mg
  • 115 mg
  • 135 mg ($$$-$$$$)
Adolescents and adults - standard-release
Adolescents and adults - extended-release tablets
  • Acne - 1 mg/kg/day (max 135 mg/day) given once daily (PI)
  • May be taken without regard to food
  • Dairy products do not affect minocycline absorption
  • Take with full glass of water to reduce risk of esophageal irritation
  • Antacids may decrease bioavailability of minocycline. Do not take within 4 hours of each other.
  • May cause photosensitivity. Limit sun exposure, use sunscreen.
  • Concomitant use of tetracyclines and isotretinoin has been associated with pseudotumor cerebri. Concurrent use should be avoided.
  • May cause hyperpigmentation around scars, shins, and mucous membranes with prolonged use
  • Minocycline should not be used in children < 8 years old because of possible tooth discoloration
  • Liver disease - use caution. Manufacturer makes no specific recommendation.
  • Kidney disease - has not been studied. Manufacturer makes no specific recommendation.
Tetracycline

(Achromycin V®)
Capsule
  • 250 mg ($)
  • 500 mg ($$$-$$$$)
Adolescents and adults
  • Take at least 1 hour before food or two hours after
  • Dairy products taken at the same time as tetracycline may decrease absorption
  • Take with full glass of water to reduce risk of esophageal irritation
  • Antacids may decrease bioavailability of tetracycline. Do not take within 4 hours of each other.
  • May cause photosensitivity. Limit sun exposure, use sunscreen.
  • Concomitant use of tetracyclines and isotretinoin has been associated with pseudotumor cerebri. Concurrent use should be avoided.
  • Tetracycline should not be used in children < 8 years old because of possible tooth discoloration
  • Kidney disease - dose reduction recommended. Manufacturer makes no specific recommendation.