Antibiotic Charts

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ANTIBIOTIC CHART
Cephalosporins
o
Cefadro
xil
(Duricef)
o
Cefdinir
(Omnicef)
o
Cefixim
e (Suprax)
Cefpod
oxime
(Vantin)
Macrolides
o
Azith
romycin
(Zithromax
)
o
Clarit
hromycin
(Biaxin)
o
Eryth
romycin
Cefproz Nitrofurantoin
o
Macr
il (Cefzil)
obid
o
Ceftriax
o
Macr
one
odantin
(Rocephin)
o
Furad
o
Cefurox
antin
ime
(Ceftin)
Nitroimidazoles
o
Cephal
o
Metro
exin
nidazole
(Keflex)
(Flagyl)
o
Tinid
azole
Clindamycin
(Tindamax
o
Clinda
)
mycin
(Cleocin)
Penicillins
o
Amo
xicillin
(Amoxil)
o
Amo
xicillinclavulana
te
(Augment
in)
o
Peni Sulfa medications

cillin G
o
Sulfame
benzathin
thoxazolee (Bicillin
trimethoprim
L-A)
(Bactrim)
Peni
cillin (Pen
VK)
Oxazolidinones
o
Linez
Fosfomycin
olid
o
Monuro
(Zyvox)
l
OTHER:
o
Recom
Dicl
oxacillin
Quinolones
o
Cipr
ofloxacin
(Cipro)
o
Gem
ifloxacin
(Factive
)
o
Levo
floxacin
(Levaquin
)
Moxi
floxacin
(Avelox)
Oflo
xacin
Tetracyclines
Doxycyc
line
o
Minocyc
line
(Minocin)
Tetracyc
line
mendation
source
o
Info on
Pricing ($)
CEPHALOSPORINS
Medicati
Dosage Form
on
Dosing
Other
Pediatric
o
Capsule
o
500
mg ($)
o
Impetigo - 30
mg/kg/day (max
1000mg/day) given
once daily or divided
into 2 doses (PI)
Skin infections
- 30 mg/kg/day (max
1000mg/day) given in
2 divided doses (PI)
Strep throat 30 mg/kg once daily
(max 1000mg/day) for
10 days (IDSA)
Urinary tract
infection - 30
mg/kg/day (max
2 divided doses (PI)
Cefadroxi Tablet
l
o
1000
mg ($-$$)
(Duricef
)
Suspension
Adults
o
250
o
Skin infections
mg/5ml,
- 1000mg/day given
500mg/5m
l ($-$$)
into 2 doses (PI)
o
Strep throat 1000mg/day given

into 2 doses for 10
days (IDSA)
Urinary tract
infection - 1000 2000mg/day given
into 2 doses for 3 - 7
days (IDSA, PI)
May take
without regard
to food
Kidney
disease - if CrCl
< 50ml/min,
dose
adjustment
required - See
Cefadroxil PI
for details
Pediatric (6 months - 12
years)
o
Otitis media 14 mg/kg/day (max
600mg/day) given in 1
or 2 divided doses for
5 - 10 days (AAP)
o
Sinusitis - 14
mg/kg/day (max
or 2 divided doses for a
minimum of 10 days
(AAP)
o
Capsule
o
300
mg ($)
Cefdinir
Skin infections
- 7 mg/kg/dose (max
300mg/dose) twice a
day for 10 days (PI)
Strep throat - 7
mg/kg/dose (max
300mg/dose) twice a
day for 5 to 10 days or
14 mg/kg (max
600mg/day) once daily
for 10 days (PI)
(Omnicef Suspension
)
o
125
Adults and Adolescents
mg/5ml,
250mg/5m (Age 13 years and Older)
o
Pneumonia,
l ($)
community-acquired
- 300 mg twice a day
for 10 days (PI)
o
Sinusitis 300mg twice a day or
600mg once daily for
10 days (IDSA)
o
Skin infections
- 300mg twice a day
for 10 days (PI)
Strep throat 300mg twice a day for

5 - 10 days or 600mg
once daily for 10 days
(PI)
Urinary tract
infection - 300mg
twice a day for 3 - 7
days (IDSA)
400 years)
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
Kidney
disease - if CrCl
< 30ml/min,
adult dose is
300mg once
daily, pediatric
dose is 7
mg/kg/day
(max
300mg/day)
given once
daily
May take
without regard
Cefixime Capsule
o
mg ($$$
$)
Tablet,
chewable
o
100
mg,
150mg,
200mg ($
$$$)
(Suprax
)
Tablet
Sinusitis - 8
mg/kg/day (max
400mg/day) given in
one or two divided
doses a day for a
minimum of 10 days.
Give with clindamycin.
See AAP sinusitis recs.
(AAP, PI)
Urinary tract
infection 8mg/kg/day (max
400mg/day) given
once daily for 7 - 14
days (CTE)
400
mg ($$$ Adults and Adolescents
$)
(Age 12 years and Older)
o
Gonorrhea Cefixime - 400mg
Suspension
single dose +
o
100
Azithromyc
mg/5ml,
in - 1000mg
200mg/5m
single dose; OR
l,
Doxycyclin
500mg/5m
e - 100mg twice
l ($$$$)
a day for 7 days
(CDC)
Cefpodoxi Tablet
Pediatric (age 2 months
me
o
100 through 12 years)
o
Otitis media mg,
(Vantin)
200mg ($
10 mg/kg/day (max
$-$$$)
divided doses for 5 - 10
days (AAP)
Suspension
o
Pneumonia,
o
50m
community-acquired
g/5ml,
- 10mg/kg/day (max
100mg/5m
l ($$-$$$)
days (IDSA)
to food
o
Kidney
disease - dose
adjustments
are necessary.
See Cefixime
PI for details.
Suspensi
on 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
Kidney
disease - for
CrCl <
30ml/min the
dosing interval
should be
increased to
Sinusitis - 10
mg/kg/day (max
divided doses for a
minimum of 10 days
(AAP)
Strep throat 10 mg/kg/day (max

days (PI)
o
Urinary tract
infection 10mg/kg/day (max
days (CTE)
Adolescents and Adults

(age 12 years and older)
o
Gonorrhea 200mg one time dose
(PI)
o
Pneumonia,
community-acquired
- Cefpodoxime 200mg
days + Macrolide
(IDSA, PI)
o
Sinusitis 200mg twice a day for

10 days (PI)
Skin infections
- 400mg twice a day
for 7 - 14 days (PI)

5 - 10 days (PI)
Urinary tract
infection - 100mg
twice a day for 3 days
(IDSA, CTE)
Cefprozil Tablet
o
250 years)
(Cefzil)
o
Cellulitis mg,
500mg ($)
20mg/kg/day (max
1000mg/day) given
Suspension
(PI)
o
125
o
Otitis media mg/5ml,
30mg/kg/day (max
250mg/5m
l ($-$$)
2 divided doses for 10
days (PI)
every 24 hours
Pneumonia,
community-acquired
- 30mg/kg/day (max
May take
without regard
to food
Kidney
disease - CrCl
29ml/min take half the
standard dose
2 divided doses for 7 10 days (IDSA)
o
Sinusitis - 15 30mg/kg/day (max

days (PI)
Strep throat 15g/kg/day (max

divided doses for 10
days (PI)

(age 12 years and older)
o
Cellulitis - 250 500mg twice a day or
500mg once daily for
10 days (PI)
o
Sinusitis - 250 500mg twice a day for
10 days (PI)
Strep throat 500mg once daily for
10 days (PI)
Ceftriaxo Vial
Pediatric
ne
o
250
o
E. coli,
mg,
enterotoxigenic (Rocephin
500mg,
50mg/kg/day IM/IV
)
1gm, 2gm
given once daily for 3
($)
days (CTE)
o
Endocarditis
prophylaxis 50mg/kg (max
1000mg) IM 30 - 60
minutes before
procedure (AHA)
o
Otitis media 50mg/kg/day (max

1000mg) IM for 1 to 3
days (AAP)
Pneumonia,
community-acquired
- 50 - 100mg/kg/day IM
(max 2000mg/day)
given once daily for 7 10 days (IDSA)
Do not
give to
neonates 28
days old with
hyperbilirubine
mia
Kidney
disease - no
dose
adjustment
necessary
Salmonella,
nontyphoidal 100mg/kg/day IV given
in 2 divided doses for 7
- 10 days (CTE)
Shigella 50mg/kg/day IM/IV

days (CTE/IDSA)
Skin infections
- 50 - 75mg/kg/day
(max 2000mg/day)
given once a day or in
two divided doses (PI)
Vibrio
vulnificus 50mg/kg/day IM/IV
days (CTE)
Adult
o
Diabetic foot
ulcer (moderate,
non-MRSA) - 1 - 2gm
IM once daily for 7 - 14
days (IDSA, PI)
Endocarditis
prophylaxis - 1 gram
IM 30 - 60 minutes
before procedure
(AHA)
Epididymitis
(likely caused by
chlamydia or
gonorrhea)
Ceftriaxone 250mg IM
single dose +
Doxycycline 100mg
(CDC)
Gonorrhea Ceftriaxone 250mg IM

single dose +
Azithromyc
in - 1000mg
single dose; OR
Doxycyclin
e - 100mg twice
a day for 7 days
(CDC)
o
Neurosyphilis
(pen-allergic) - 2gm
IM/IV daily for 10 - 14
days (CDC)
Pneumonia,
community-acquired
- Ceftriaxone 1gm IM/IV
days + Macrolide
(IDSA, CTE)
Salmonella,
nontyphoidal - 1 2gm IV once daily for 5
- 10 days (CTE/IDSA)
Syphilis
(primary and
secondary, penallergic) - 1gm IM/IV
daily for 10 - 14 days
(CDC)
Cefuroxi Tablet
Pediatric (3 months to 12
me
o
125 years)
NOTE: Pediatric dosing is for
mg,
(Ceftin)
suspension only. Suspension
250mg,
500mg ($) and tablet are not
bioequivalent on a mg-to-mg
basis.
o
Impetigo Suspension
o
125
30mg/kg/day given in
2 divided doses (max
mg/5ml,
1000mg/day) for 10
250mg/5m
days (PI)
l ($-$$)
o
Otitis media 30mg/kg/day (max
2 divided doses for 5 10 days (AAP)
o
Pneumonia,
community-acquired
- 30mg/kg/day (max
2 divided doses for 7 10 days (IDSA)
Sinusitis 30mg/kg/day given in

Suspensi
on 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
CrC
l
30ml/min
- no
adjustme
nt
necessar
y
CrC
1000mg/day) for a
minimum of 10 days
(AAP)
o
Strep throat 20mg/kg/day given in

500mg/day) for 10
days (PI)
Urinary tract
infection - 20 30mg/kg/day (max
2 divided doses for 7 14 days (CTE)

(13 years and older)
o
Bite, animal Cefuroxime 500mg
twice a day +
Clindamyci
n 300mg 3 times
a day; OR
Metronidaz
ole 250 - 500mg
3 times a day
(IDSA)
Early Lyme
disease - 500mg twice
a day for 20 days (PI)
Gonorrhea 1000mg one time dose

(PI)
Pneumonia,
community-acquired
- Cefuroxime 500mg
days + Macrolide
(IDSA, PI)

10 days (PI)
Skin infections
- 250 - 500mg twice a
day for 10 days (PI)
Strep throat -
l 10 - 29 give
standard
individual
dose
every 24
hours
CrC
l<
10ml/min
- give
standard
individual
dose
every 48
hours
250mg twice a day for

10 days (PI)
Urinary tract
infection - 250mg
(IDSA, PI)
Cephalexi Capsule
Pediatric
n
o
250
o
Cellulitis (nonmg,
MRSA) - 25 (Keflex)
500mg ($)
50mg/kg/day (max
o
750
4 divided doses for 5 mg ($$$)
10 days (IDSA)
o
Endocarditis
Tablet
prophylaxis o
250
50mg/kg (max
2000mg) 30 - 60
mg,
minutes before
500mg ($)
procedure (penicillin
allergic without severe
reaction) (AHA)
Suspension
o
125
o
Impetigo - 25
mg/5ml,
50mg/kg/day (max
250mg/5m
l ($)
days (IDSA)
o
Otitis media 75 - 100mg/kg/day

given in 4 divided
doses for 5 - 10 days
(PI)
Strep throat 40mg/kg/day (max

days (IDSA)
Urinary tract
4 divided doses for 7 14 days (CTE)
Adults (15 years and

older)
o
Cellulitis (nonMRSA) - 500mg 4
times a day for 5 - 10
days (IDSA)
May take
without regard
to food
Cephalexi
n may increase
metformin
levels
Kidney
disease clearance is
reduced.
Manufacturer
makes no
specific
recommendatio
ns.
Diabetic foot
ulcer (mild, nonMRSA) - 500mg 4
days (IDSA)
Endocarditis
prophylaxis - 2 grams
30 - 60 minutes before
allergic without severe
reaction) (AHA)
Impetigo 250mg 4 times a day

for 7 days (IDSA)

10 days (IDSA)
Urinary tract
infection - 500mg
(IDSA, PI)
Urinary tract
infection,
prophylaxis
Postcoital 250mg one time

postcoital (CTE)
Continuous
- 125 - 250mg
once daily (CTE)
CLINDAMYCIN
Medicati
Dosage Form
Dosing
on
Clindamy Capsule
Pediatric
cin
o
75m
o
Cellulitis (MRSA
g, 150mg,
coverage) - 30 (Cleocin
300mg ($)
40mg/kg/day (max
)
divided doses for 5 - 10 days
Solution
(IDSA)
o
75m
o
Endocarditis
g/5ml ($$)
prophylaxis - 20mg/kg (max
600mg) 30 - 60 minutes
Other
o
M
ay take
without
regard
to food
Ki
dney
disease
- no
before procedure (penicillin

allergic) (AHA)
Vaginal cream
o
2%,
40gm tube
($-$$)
Vaginal
suppository
o
100
mg ($$$)
Impetigo 20mg/kg/day (max

divided doses for 7 days
(IDSA)
Otitis media - 30
40mg/kg/day (max
1800mg/day) in 3 divided
doses for 5 - 10 days (AAP)
Topical
Sinusitis - 8 12mg/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 7mg/kg/dose 3 times daily

(max = 300 mg/dose) for 10
days (IDSA)
See
Topical
derm
chart
Adults
o
Bacterial vaginosis
Clindamycin
vaginal cream 2% - one
full applicator (5g)
intravaginally at
bedtime for 7 days
(CDC)
Clindamycin oral 300mg twice a day for

7 days (CDC)
Clindamycin
vaginal suppository 100mg intravaginally
once at bedtime for 3
days (CDC)
Bite, animal Clindamycin - 300mg 3 times

a day +
Cefuroxime
(Ceftin) - 500mg
twice a day; OR
Levofloxacin
dose
adjustm
ent
necessa
ry
(Levaquin) - 750mg
once daily; OR
Sulfamethoxazole
-trimethoprim 800/160 twice a day
(IDSA)
Cellulitis (MRSA
coverage) - 300 - 450mg 4
times a day for 5 - 10 days
(IDSA)
Diabetic foot ulcer

(mild) - 300 - 450mg 4 times
a day for 7 - 14 days (IDSA)
Diabetic foot ulcer

(moderate) - Clindamycin
300 - 450mg 4 times a day +
Ciprofloxacin
500mg twice a day for
7 - 14 days; OR
Levofloxacin
750mg once daily for 7
- 14 days (IDSA)
Endocarditis
prophylaxis - 600mg 30 - 60
minutes before procedure
(penicillin allergic) (AHA)
Hidradenitis
suppurativa - Clindamycin
300mg twice a day +
Rifampin 600mg once daily
for 10 weeks (19590173);
also topical clindamycin
applied twice a day (CTE)
Impetigo - 300 - 400

mg 4 times a day for 7 days
(IDSA)
Pseudofolliculitis
barbae - Benzoyl peroxide +
topical clindamycin applied
twice a day (CTE)
Strep throat - 300mg

three times a day for 10 days
(IDSA)
FOSFOMYCIN
Medicati
on
Dosage
Form
Dosing
Adults
Urinary
tract infection 3gm packet one
time dose (IDSA,
PI)
Urinary
tract infection,
prophylaxis 3gm packet
every 10 days
(CTE)
Fosfomyc Powder
o
3
in
gm
(Monurol
packet
)
($$)
Other
o
May take without

regard to food
Mix packet with 3

- 4oz of water
Kidney disease clearance is decreased.

Manufacturer makes no
specific dosage
recommendations.
MACROLIDES
Medicati
Dosage Form
Dosing
on
Azithromy Tablet
Pediatric
cin
o
250
o
Campylobacter mg,
10mg/kg/day (max
(Zithroma
500mg,
500mg/day) given once
x)
600mg
daily for 3 - 5 days (CTE)
($)
o
Cat scratch disease
< 45kg 10mg/kg (max 500mg)

on Day 1 followed by
5mg/kg/day (max
250mg/day) on Days 2
-5
> 45kg - 500mg

on Day 1 followed by
250mg once daily on
Days 2 - 5 (IDSA)
Suspension
o
100
mg/5ml,
200mg/5
ml ($)
Packet of
powder
o
100
0mg ($-$
$)
Suspension,
extendedrelease
(Zmax)
o
2g
E. coli,
enterotoxigenic 10mg/kg/day (max
daily for 3 days (CTE)
Endocarditis
prophylaxis -15mg/kg
(max 500mg) 30 - 60
Other
o
May
take
without
regard to
food
Do
not take
with
aluminum
or
magnesiu
m antacids
Kidn
ey disease
- CrCl > 10
ml/min - no
dose
adjustment
necessary;
CrCl <
10ml/min use caution
m/bottle
($$$)

o
Pneumonia,
community-acquired,
atypical - 10mg/kg (max
500mg) on Day 1 followed
by 5mg/kg/day (max
daily on Days 2 - 5 (IDSA)
Salmonella
(nontyphoidal) 20mg/kg/day (max
Shigella 10mg/kg/day (max

Strep throat 12mg/kg/day (max 500

mg/day) given once daily for
5 days (IDSA)
Vibrio vulnificus 10mg/kg/day (max

Ophthalmic
o
See
Conjunc
tivitis
Adults
o
Campylobacter 500mg once daily for 3 days

(CTE)
Cat scratch disease
- 500 mg on day 1 followed
by 250 mg for 4 additional
days (IDSA)
Chlamydia - 1000mg
single dose (CDC)
E. coli,
enterotoxigenic - 1000mg
given as a single dose (CTE)
Gonorrhea
Azithromycin
1000mg single dose +
ceftriaxone 250mg IM
single dose (CDC,
preferred)
Azithromycin
cefixime 400mg single
dose (CDC,
alternative)
Azithromycin
2000mg single dose
(CDC, alternative)
Azithromycin
gemifloxacin 320mg
single dose (based on
PMID 25031289)
Azithromycin
gentamicin 240mg IM
PMID 25031289)
Endocarditis
prophylaxis - 500mg 30 60 minutes before
allergic) (AHA)
Mycoplasma
genitalium - 1000mg one
time dose (CDC)
Pneumonia,
community-acquired
Azithromycin 500mg on Day 1

followed by 250mg
once daily on Days 2 5 (IDSA, PI)
Extendedrelease (Zmax) 2000mg one time

dose (PI)
Prostatitis, chronic 500mg once daily for 4 - 6

weeks (CTE)
Salmonella
(nontyphoidal) - 500mg
once daily for 7 days (CTE)
Shigella - 500mg
once daily for 3 days (CTE)

o

once daily for 5 days (IDSA)
Syphilis (primary
and secondary, penallergic) - 2000mg single
dose (CDC)
Vibrio vulnificus 500mg once daily for 3 days

(CTE)
Clarithro Tablet
Pediatric
mycin
o
250
o
Endocarditis
mg,
prophylaxis - 15mg/kg
(Biaxin)
500mg
(max 500mg) 30 - 60
($)
o
H. pylori Tablet,
Clarithromycin extended20mg/kg/day (max
release
(Biaxin XL)
divided doses +
o
500
Amoxicillin mg ($-$
50mg/kg/day (max
$)
2 divided doses +
Suspension
Proton Pump
o
125
Inhibitor (PPI) (CTE)
mg/5ml,
250mg/5
DURATION:
ml ($$)
10 - 14 days
o
H. pylori, sequential
therapy - see H. pylori
treatment
Pneumonia,
community-acquired,
atypical - 15mg/kg/day
(max 1000mg/day) given in
2 divided doses for 7 - 10
days (IDSA)

divided doses for 10 days
(IDSA)
Adults
o
Endocarditis
Stan
dardrelease
tablet and
suspension
may be
taken
without
regard to
food.
Extendedrelease
tablets
should be
taken with
food.
Clarit
hromycin is
a Strong
CYP3A4
inhibitor
Kidn
ey disease
- CrCl < 30
ml/min reduce
dose by
50%
prophylaxis - 500mg 30 60 minutes before

allergic) (AHA)
H. pylori Clarithromycin - 500mg
twice a day +
Proton Pump
Inhibitor (PPI) +
Amoxicillin 1000mg twice a day;

OR
Metronidazole 500mg twice a day

(ACG)
DURATION:
10 - 14 days
treatment
Pneumonia,
community-acquired
Standard-release
- 250mg twice a day
for 7 - 14 days (IDSA,
PI)
Extendedrelease - 1000mg once

daily for 7 days (IDSA,
PI)
Prostatitis, chronic 500mg twice a day for 4 - 6

weeks (CTE)
Sinusitis
Standard-release
- 500mg twice a day
for 14 days (PI)
Extendedrelease - 1000mg once

daily for 14 days (PI)
Skin infections 250mg twice a day for 7 - 14

days (PI)

(IDSA)
Erythrom Erythromycin Pediatric
ycin
base
o
Campylobacter
Erythromycin
(Eryc) Capsule,
base - 30mg/kg/day
(E.E.S.) enteric
given in 2 - 4 divided
(Eryped coated
)
(Eryc)
(CTE)
o
250
o
Impetigo
mg ($$-$
$$)
Erythromycin
ethylsuccinate 40mg/kg/day (max
Tablet,
enteric
3 4 divided doses for
coated (Ery7 days (IDSA)
tab)
o
250
o
Pneumonia,
mg,
community-acquired,
333mg,
atypical
500mg
Erythromycin
($$$-$$
ethylsuccinate
$$)
40mg/kg/day (max
4 divided doses for 7 Tablet,
10 days (IDSA)
enteric
coated
(PCE)
o
333 Adolescents and adults
o
Acne
mg,
Erythromycin
500mg
base
250 - 500mg
($$-$$$)
once daily or 250 500mg twice a day
(AAP)
Tablet
o
250
o
Campylobacter
mg,
500mg
Erythromycin
($$-$$$
base - 500mg 2 - 4
$)
o
days (IDSA/CTE)
Ophthalmic
o
See
Conjunc
tivitis
Topical
o
See
Chlamydia
Erythromycin
base - 500mg 4 times
a day for 7 days (CDC)
Erythromycin
ethylsuccinate 800mg 4 times a day
May
take
without
regard to
food
400
mg of
erythromyc
in
ethylsuccin
ate is
equivalent
to 250mg
of
erythromyc
in base or
stearate
Eryth
romycin is
a
Moderate
CYP3A4
inhibitor
Kidn
ey disease
erythromyc
in is mostly
excreted in
the bile.
Manufactur
er makes
no specific
recommen
dation.
Topical
derm
meds
Erythromycin
Ethylsuccinat
e
for 7 days (CDC)
Tablet
(E.E.S.)
o
400
mg ($$$$$$$)
Granule
(E.E.S.,
Eryped)
o
200
mg/5ml,
400mg/5
ml ($$$
$)
Suspension
(E.E.S.,
Pediamycin
)
o
200
mg/5ml,
400mg/5
ml ($$$
$)
Impetigo
Erythromycin
a day for 7 days
(IDSA)
Erythromycin
for 7 days (IDSA)
Pneumonia,
community-acquired
Erythromycin
a day or 1000mg twice
a day for 7 - 14 days
(IDSA, CTE) [2]
Erythromycin
or 1600mg twice a day
for 7 - 14 days
Erythromycin
Stearate
Tablet
250
mg
NITROIMIDAZOLES
Medicati
Dosage
Dosing
on
Form
Metronida Capsule
Pediatric
zole
o
3
o
Clostridium difficile -
Other
o
May
take
75mg
($$)
(Flagyl)
Tablet
o
2
50mg,
500mg
($)
Tablet,
extendedrelease
(Flagyl
ER)
7.5mg/kg/dose (max
500mg/dose) given 3 times a
day for 10 - 14 days (CTE)
Entamoeba histolytica
- 35 - 50mg/kg/day (max
divided doses for 10 days (PI)
Giardia - 5mg/kg/dose
(max 250mg/dose) 3 times a
day for 7 - 10 days (CTE)
H. pylori Metronidazole - 20mg/kg/day

(max 1000mg/day) given in 2
divided doses +
50mg
($$$$)
Topical
o
Amoxicillin 50mg/kg/day (max

divided doses +
Proton Pump
Inhibitor (PPI) (CTE)
S
ee
topica
l derm
meds
Pote
ntial for
disulfiram
-like
reaction if
taken with
alcohol.
Do not
ingest
alcohol
during, or
for 3 days
after
stopping
metronida
zole.
Kidn
DURATION:
10 - 14 days
treatment
Adults
o
standardrelease
without
regard to
food.
Extendedrelease
should be
taken one
hour
before or
2 hours
after
meals.
Bacterial vaginosis
Metronidazole 500mg twice a day for 7
days (CDC)
Metronidazole gel
0.75% - one full
applicator (5g)
intravaginally once daily
for 5 days (CDC)
Metronidazole
extended-release 750mg once daily for 7
days (PI)
Bite, animal Metronidazole - 250 - 500mg 3

times a day +
Cefuroxime -
ey
disease patients
with endstage
renal
disease
may have
decreased
clearance.
Manufactu
rer makes
no
specific
dosage
recomme
ndations.
500mg twice a day; OR
Levofloxacin 750mg once daily; OR
Sulfamethoxazoletrimethoprim - 800/160
twice a day (IDSA)
Bite, human Metronidazole - 250 - 500mg 3

times a day +
Ciprofloxacin 500mg - 750mg twice a

day (IDSA)
Clostridium difficile 500mg 3 times a day for 10 14 days (IDSA)
Diverticulitis Metronidazole - 500mg 3 - 4

times a day +
Ciprofloxacin 500mg twice a day; OR
Sulfamethoxazoletrimethoprim - 800/160
twice a day
DURATION: 7
- 14 days
- 750mg 3 times a day for 5 10 days (IDSA/CTE)
Giardia - 250mg 750mg 3 times a day for 7 - 10

days (IDSA); OR 500mg twice
a day for 5 - 7 days (CTE)
H. pylori Metronidazole - 500mg twice a

day +
Clarithromycin 500mg twice a day +

Proton Pump
Inhibitor (PPI) (ACG)
DURATION:
10 - 14 days
treatment
Trichomoniasis 2000mg single dose; OR

500mg twice a day for 7 days
(CDC)
Pediatric (3 years and older)

o
- 50mg/kg/day (max
2000mg/day) given once daily
for 3 days (PI)
o
Giardia - 50mg/kg (max
2000mg) given as a one time
dose (PI)
Adults
o
Tinidazole
(Tindamax
)
Tablet
o
2
50mg,
500mg
($-$$)
NITROFURANTOIN
Take
with food
to
minimize
stomach
upset
Tini
dazole is
a CYP3A4
sensitive
substrate
Pote
ntial for
disulfiram
-like
reaction if
taken with
alcohol.
Do not
ingest
alcohol
during, or
for 3 days
after
stopping
tinidazole.
Kidn
ey
disease No dose
adjustmen
t
necessary
Bacterial vaginosis
2000mg once daily
for 2 days (CDC)
1000mg once daily
for 5 days (CDC)
- 2000mg once daily for 3 days
(PI)
Giardia - 2000mg given

as a one time dose (CTE/PI)
treatment
Trichomoniasis 2000mg single dose (CDC)
Medicatio
Dosage Form
n
Dosing
Pediatric (one month and

older)
o
Urinary tract
infection
Macrodantin
and
Furadantin - 5 7mg/kg/day given
Nitrofurantoin
in 4 divided doses
monohydrate
for 7 days (PI)
:
Nitrofurantoin
o
Urinary tract
macrocrystalli
infection,
ne
prophylactic
Other
Take
with food
Macrodantin
and
Furadantin - 1 2mg/kg/day given
once daily (CTE)
Do not
take with
antacids
containing
magnesium
Nitrofuranto
Nitrofurantoin Adults
in
macrocrystalli
o
Urinary tract
(Macrobid ne
infection
)
Macrobid
(Macrodanti Capsule,
- 100mg twice a
Macrodantin
n)
day for 5 days
o
25
(Furadantin
(IDSA)
)
mg,
50mg,
Macrodantin
100mg
- 50 - 100mg 4
($)
times a day for 7
days (PI)
Nitrofur
antoin has
been
associated
with rare
cases of
interstitial
lung disease
in patients
who took it
for 6
months
Kidney
disease CrCl <
60ml/min do not use
Capsule,
Macrobid
o
75
mg :
25mg ($)
Nitrofurantoin
Suspension,
Furadantin
o
25
mg/5ml
($$$$)
Urinary tract
infection,
prophylaxis
Postcoital 50 - 100mg one

time postcoital
(Macrobid or
Macrodantin)
(CTE)
Continuous
- 50 - 100mg once
daily (Macrobid
or Macrodantin)
(CTE)
OXAZOLIDINONES
Medicati
Dosage Form
Dosing
on
Linezolid Tablet
Pediatric
o
600m
o
Cellulitis
(Zyvox)
g ($$$$)
(MRSA
coverage)
<5
Suspension
years old o
100m
10mg/kg/d
g/5ml ($$$
ose every 8
$)
hours for 5
- 10 days
(IDSA, PI)
5 - 11
years old 10mg/kg/d
ose (max
600mg/dos
e) twice a
day for 5 10 days
(IDSA, PI)
Other
o
May take
without regard to
food
Do not take
within 2 weeks of a
MAO inhibitor.
Linezolid is a
reversible,
nonselective MAO
inhibitor.
May increase
pressor effect of
adrenergic agents
including
pseudoephedrine
and
phenylpropanolami
ne. Foods
containing tyramine
should also be
avoided in large
quantities (e.g.
aged cheeses,
fermented or airdried meats,
sauerkraut, soy
sauce, tap beers,
and red wines)
Has been
associated with
Serotonin
syndrome. Use
caution when
taking with
antidepressants.
Kidney
disease - no dose
adjustment
necessary
Pneumoni
a, communityacquired
< 12
years old 30mg/kg/d
ay given in
3 divided
doses for 7
- 10 days
(IDSA)
12
years old 20mg/kg/d
ay (max
1200mg/da
y) given in
2 divided
doses for 7
- 10 days
(IDSA)
Adults (12 years and
older)
o
Cellulitis
(MRSA
coverage) 600mg twice a
day for 5 - 10
days (IDSA)
Diabetic
foot ulcer
(moderate,
MRSA
coverage) - 400
- 600mg twice a
day for 7 - 14
days (IDSA)
Pneumoni
a, communityacquired 600mg twice a
day for 10 - 14
days (PI)
PENICILLINS
Medic
Dosage Form
Dosing
ation
Amoxic Capsule
Pediatric
illin
o
250
o
Endocarditis
mg,
prophylaxis (Amoxil
500mg ($)
50mg/kg (max
)
2000mg) 30 - 60
minutes before
Tablet
procedure (AHA)
o
500
o
H. pylori mg,
Amoxicillin 875mg ($)
50mg/kg/day (max
2000mg/day) given
in 2 divided doses +
Tablet,
Proton
chewable
Pump
Inhibitor
o
125
(PPI) +
mg,
250mg ($)
Clarithro
mycin 20mg/kg/day
Tablet,
(max
extended1000mg/day)
release
given in 2
(Moxatag)
divided doses;
Other
o
May take
without regard to
food
Kidney
disease - CrCl 10 30ml/min - 250 500mg every 12
hours; CrCl <
10ml/min - 250 500mg every 24
hours
775
mg ($$$)
OR
Suspension
o
125
mg/5ml,
200mg/5m
l,
250mg/5m
l,
400mg/5m
l ($)
Metronid
azole 20mg/kg/day
(max
1000mg/day)
given in 2
divided doses
(CTE)
DU
RATION:
10 - 14
days
H. pylori,
sequential therapy
- see H. pylori
treatment
Otitis media 80 - 90mg/kg/day

given in 2 divided
(AAP)
Pneumonia,
communityacquired 90mg/kg/day (max
4000mg/day) given
in 2 divided doses for
7 - 10 days (IDSA)
Sinusitis
Standard
therapy 45mg/kg/day
given in 2
divided doses
for a minimum
of 10 days
(AAP)
Highdose therapy 80 to
90mg/kg/day
(max
4000mg/day)
given in 2
divided doses
for a minimum
of 10 days
(AAP)
o

1000mg/day) given
once daily or in 2
divided doses for 10
days (IDSA)
Adults
o
Endocarditis
prophylaxis 2000mg 30 - 60
minutes before
procedure (AHA)
H. pylori Amoxicillin - 1000mg
twice a day +
Clarithro
mycin - 500mg
twice a day +
Proton
Pump Inhibitor
(PPI) (ACG)
DU
RATION:
10 - 14
days
H. pylori,
sequential therapy
- see H. pylori
treatment
Pneumonia,
communityacquired Amoxicillin 1000mg
3 times a day for 7 14 days + Macrolide
(IDSA)
Strep throat 1000mg once a day

or 500mg twice a
day for 10 days
(IDSA)
Amoxic Tablet
Pediatric
illin(amoxil : clav)
o
Impetigo clavula
o
250
25mg/kg/day (max
nate
mg :
1750mg/day) of the
o
May take
without regard to
meals, although
taking with food
(Augm
entin
)
125mg ($
$)
500
mg :
125mg ($)
875
mg :
125mg ($)
Tablet,
chewable
(amoxil : clav)
o
7:1
ratio
Pneumonia,
communityacquired 90mg/kg/day (max
4000mg/day) given
7 - 10 days (IDSA)
Sinusitis - 80
90mg/kg/day of the
amoxicillin
component with 6.4
mg/kg/day of
clavulanate
[amoxicillin to
clavulanate ratio,
14:1] in 2 divided
doses (max
4000mg/day) for a
minimum of 10 days
(AAP)
Urinary tract
infection - 20 40mg/kg/day given
7 - 14 days (CTE)
200mg :
28.5
mg
400mg :
57m
g,
($)
4:1
ratio
125mg :
31.2
5mg
250mg :
62.5
mg
amoxicillin
component given in
days (IDSA)
Otitis media 90mg/kg/day of
amoxicillin, with 6.4
mg/kg/day of
clavulanate
[amoxicillin to
clavulanate ratio,
14:1] (max
4000mg/day) in 2
divided doses for 5 10 days (AAP)
Tablet,
extendedrelease
(Augmentin
XR)
Adults
o
1000
o
Bite, animal mg :
875/125mg twice a
62.5mg ($
day (IDSA)
$)
o
Bite, human 875/125mg twice a
day (IDSA)
Suspension
(amoxil:clav)
o
Diabetic foot
o
4:1
ulcer (mild, non-
may help reduce

gastrointestinal
upset
o
Amoxicillinclavulanate
preparations with a
14:1 ratio of
amoxicillinclavulanate may be
less likely to cause
diarrhea than
preparations with a
lower ratio
Kidney
disease - for
standard tablet and
suspension - CrCl <
30ml/min - do not
give 875mg dose;
CrCl 10 - 30ml/min:
250 - 500mg every
12 hours; CrCl <
10: 250 - 500mg
every 24 hours
MRSA) - 875/125mg
days (IDSA)
ratio
125mg :
31.2
5mg/
5ml
Diverticulitis
- 875/125mg twice a
day for 7 - 14 days
(CTE)
Impetigo 875/125mg twice a

day for 7 days (IDSA)
Pneumonia,
communityacquired Amoxicillinclavulanate 2000mg
two times a day for 7
- 14 days +
Macrolide (IDSA)
Sinusitis
250mg :
62.5
mg/5
ml
($)
7:1
ratio
200mg :
28.5
mg/5
ml
Standard
therapy 875/125mg
twice a day for
5 - 7 days
(IDSA)
Highdose therapy 2000mg twice

a day for 5 - 7
days (IDSA)
400mg :
57m
g/5m
l ($)
o
14:1
ratio
(Augment
in ES)
600mg :
42.9
mg/5
ml
($)
Urinary tract
infection 875/125mg twice a
day for 3 - 7 days
(IDSA)
Dicloxa Capsule
Pediatric
cillin
o
250
o
Cellulitis
mg,
(non-MRSA) - 25 500mg ($)
50mg/kg/day (max
2000mg/day) given
o
125
5 - 10 days (IDSA)
mg
o
Adults
o
Cellulitis
(non-MRSA) 500mg 4 times a day
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.
for 5 - 10 days (IDSA)

Diabetic foot
ulcer (mild, nonMRSA) - 500mg 4
days (IDSA)
Impetigo 250mg 4 times a day

for 7 days (IDSA)
Penicilli Disposable
Pediatric
nG
syringe
o
Strep throat
benzat
o
1ml
< 27 kg hine
600,000
600,000 units
units ($$)
IM single dose
(Bicillin
o
2ml (IDSA)
L-A)
1,200,000
27 kg units ($$
1,200,000
$)
units IM single
dose (IDSA)
o
4ml 2,400,000
o
Impetigo
units ($$$
$)
6kg 225mg
(300,000 units)
IM given as a
one time dose
o
6.1 10kg 337.5mg

(450,000 units)
IM given as a
one time dose
10.1 15kg - 450mg
(600,000 units)
IM given as a
one time dose
15.1 20kg - 675mg
(900,000 units)
IM given as a
one time dose
> 20kg 900mg
(1,200,000
units) IM given
as a one time
dose
For IM use
only
Kidney
disease - clearance
is decreased.
Manufacturer
makes no specific
recommendation.
Milligra
m-unit
conversion
2
25mg =
300,00
0 units
3
37.5mg
=
450,00
0 units
4
50mg =
600,00
0 units
6
75mg =
900,00
0 units
9
00mg =
1,200,0
00 units
(Do
sing
based on
PMID
2517237
6)
Adults
o
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)
Penicilli Tablet
Pediatric
n
o
250
o
Strep throat mg,
250mg 2 - 3 times a
(Pen
500mg ($)
day for 10 days
VK)
(IDSA)
Solution
o
125 Adults
o
Cellulitis
mg/5ml,
250mg/5m
(Streptococcal
l ($)
infections) - 250 500mg 4 times a day
for 5 - 10 days (IDSA)
o
Strep throat -
May take
without regard to
meals
Kidney
disease - drug
clearance is
decreased.
Manufacturer
makes no specific
dosage
recommendations.
250mg 4 times daily

or 500 mg twice a
day (IDSA)
QUINOLONES
Medicati
Dosage Form
Dosing
on
Ciprofloxa Suspension
Pediatric ( 1 year old)
cin
o
250m
o
Urinary tract
g/5ml ($$infection - 10 (Cipro)
$$$)
20mg/kg/dose
o
500m
(maximum 750mg/dose)
every 12 hours for 7 - 14
g/5ml ($$days (PI)
$$$)
Tablet
o
100m
g, 250mg,
500mg,
750mg ($)
Tablet,
extendedrelease
o
Otic
o
May
take without
regard to
food
Do not
take with
tizanidine
(Zanaflex)
Bite, human Ciprofloxacin - 500 750mg twice a day +

metronidazole 250 500mg 3 times a day
(IDSA)
Diabetic foot
ulcer (moderate) Ciprofloxacin 500mg
twice a day +
clindamycin 300 450mg 4 times a day for
7 - 14 days (IDSA)
Take 2
hours before
or 6 hours
after
magnesium
or aluminum
antacids
Ciprofl
oxacin is a
Strong
CYP1A2
inhibitor
Diverticulitis Ciprofloxacin 500mg

twice a day +
metronidazole 500mg 3 4 times a day for 7 - 14
days (CTE)
E Coli,
enterotoxigenic 500mg twice a day or
750mg once daily for 1 3 days (CTE/IDSA)
Prostatitis,
acute - 500mg twice a
day for 2 - 4 weeks (CTE)
Prostatitis,
chronic - 500mg twice a
Kidney
disease
Standardrelease:
CrCl >
50ml/min no dose
adjustment
necessary;
CrCl 30 50ml/min 250 - 500mg
every 12
hours; CrCl 5
- 29ml/min 250 - 500mg
every 18
hours;
Extended-
Adults
o
500m
g, 1000mg
($-$$)
Ophthalmic
o
See
Conjuncti
vitis
See
Otitis
externa
Other
day for 4 - 6 weeks (CTE,

PI)
Pyelonephritis
Standardrelease - 500mg
twice a day for 7
days (IDSA)
Extendedrelease - 1000mg
once daily for 7
days (IDSA)
NOTE: If
community
resistance to
fluoroquinolones is
> 10%, then also
give Ceftriaxone
1000mg IM one
time dose (IDSA)
Salmonella,
nontyphoidal - 500mg
days (CTE/IDSA)
Shigella - 750mg
once daily or 500mg
(CTE/IDSA)
Sinusitis - 500mg
(PI)
Urinary tract
infection
Standardrelease - 250mg
twice a day for 3
days (IDSA, PI)
Extendedrelease - 500mg
once daily for 3
days (IDSA, PI)
Vibrio vulnificus
- 750mg once daily for 3
days (CTE)
Adults
320m
o
Gonorrhea -
release CrCl
30ml/min 500mg once
daily
Gemifloxa Tablet
cin
o
May
take without
regard to
food
(Factive
)
g ($$$$)
o
Antaci
ds,
sucralfate,
metal
cations (e.g.
iron), and
multivitamin
s may
reduce
gemifloxacin
absorption.
Gemifloxacin
should be
taken 3
hours before
or 2 hours
after these
medications.
Kidney
disease CrCl
40ml/min 160mg
every 24
hours
May
take without
regard to
food
gemifloxacin 320mg
single dose +
azithromycin 2000mg
PMID 25031289)
Pneumonia,
community-acquired 320mg once daily for 5 7 days (IDSA, PI)
Levofloxa Tablet
Pediatric
cin
o
250m
o
Pneumonia,
g, 500mg,
community-acquired
(Levaquin
750mg ($)
6 months - 5
)
years old - 16 20mg/kg/day given
Solution
in 2 divided doses
o
25mg
for 7 - 10 days
/ml ($$)
(IDSA)
Ophthalmic
o
See
Conjuncti
vitis
Antaci
ds,
sucralfate,
metal
cations (e.g.
iron), and
multivitamin
s may
reduce
levofloxacin
absorption.
Do not take
within 2
hours of
each other.
Quinol
ones have
not been
considered
5 - 16 years
old - 8 10mg/kg/day (max
750mg/day) given
once daily for 7 10 days (IDSA)
Sinusitis 16mg/kg/day (max

divided doses for a
minimum of 10 days
(AAP)
Adults
o
Bite, animal Levofloxacin 750mg

once daily +
clindamycin
300mg 3 times a
day; OR
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]
metronidazol
e 250 - 500mg 3
times a day (IDSA)
Bite, human Levofloxacin 750mg

once daily +
metronidazole 250 500mg 3 times a day
(IDSA)
Chlamydia 500mg once daily for 7

days (CDC)
Diabetic foot
ulcer (mild, nonMRSA) - 750mg once
(IDSA)
Diabetic foot
ulcer (moderate) Levofloxacin 750mg
once daily + clindamycin
300 - 450mg 4 times a
day for 7 - 14 days
(IDSA)
Diverticulitis Levofloxacin 750mg

once daily +
metronidazole 500mg 3 4 times a day for 7 - 14
days (CTE)
Epididymitis
(likely caused by
urinary tract
pathogens) - 500mg
(CDC)
H. pylori Levofloxacin 500mg

once daily + amoxicillin
1000mg twice a day +
Kidney
disease dose
adjustment
necessary.
See
Levaquin
PI for more.
PPI for 10 days (ACG)

o
Pneumonia,
community-acquireda 500mg once daily for 7 14 days (PI)
Pneumonia,
community-acquiredb 750mg once daily for 5
days (IDSA, PI)
Pneumonia,
nosocomial - 750mg
once daily for 7 - 14 days
(PI)
Prostatitis,
acute - 500mg - 750mg
weeks (CTE)
Prostatitis,
chronic - 500mg once
daily for 4 - 6 weeks
(CTE, PI)
Pyelonephritis 750mg once daily for 5

days; if community
resistance to
fluoroquinolones
is > 10%, then also give
one time dose (IDSA)
Salmonella,
(CTE/IDSA)
Sinusitis - 750mg
once daily for 5 days or
500mg once daily for 10
- 14 days (IDSA, PI)
Skin infections,
complicated - 750mg
(PI)
Skin infections,
uncomplicated 500mg once daily for 7 10 days (PI)
Urinary tract
infection - 250mg once
daily for 3 days (IDSA,
PI)
Urinary tract
infection,
complicatedc - 750mg
once daily for 5 days (PI)
Urinary tract
infection,
complicatedd - 250mg
(PI)
Due to methicillinsusceptible
Staphylococcus aureus,
Streptococcus
pneumoniae (including
multidrug-resistant
isolates [MDRSP]),
Haemophilus influenzae,
Haemophilus
parainfluenzae,
Klebsiella pneumoniae,
Moraxella catarrhalis,
Chlamydophila
pneumoniae, Legionella
pneumophila, or
Mycoplasma
pneumoniae
b
Due to
Streptococcus
pneumoniae (excluding
multi-drug-resistant
isolates [MDRSP]),
Haemophilus influenzae,
Haemophilus
parainfluenzae,
Mycoplasma
pneumoniae, or
Chlamydophila
pneumoniae
c
due to
Escherichia coli,
Proteus mirabilis and
pyelonephritis due to E.
coli, including cases with
concurrent bacteremia
Enterococcus
faecalis, Enterococcus
cloacae, Escherichia coli,
Proteus mirabilis,
Pseudomonas
aeruginosa; and for
pyelonephritis due to E.
coli
Adults
o
Bite, animal 400mg once daily (IDSA)
o
Bite, human 400mg once daily (IDSA)
o
Diverticulitis 400mg once daily for 7 14 days (CTE)
Mycoplasma
genitalium - 400mg
(CDC)
Pneumonia,
community-acquired 400mg once daily for 7 14 days (IDSA, PI)
Sinusitis - 400mg
(IDSA, PI)
Skin infections,
uncomplicated 400mg once daily for 7
days (PI)
Tablet
o
Moxifloxa
cin
(Avelox)
400m
g ($$-$$$)
Ophthalmic
o
See
Conjuncti
vitis
Diabetic foot
ulcer (moderate, nonMRSA) - 400mg once
(IDSA)
Skin infections,
complicated - 400mg
(PI)
Ofloxacin Tablet
Adults
o
200m
o
Chlamydia g, 300mg,
300mg twice a day for 7
400mg ($
days (CDC)
$)
o
E. coli,
enterotoxigenic 300mg twice a day for 3
May
take without
regard to
food
Antaci
ds,
sucralfate,
metal
cations (e.g.
iron), and
multivitamin
s may
reduce
moxifloxacin
absorption.
Moxifloxacin
should be
taken 4
hours before
or 8 hours
after these
medications.
Kidney
disease - no
dose
adjustment
necessary
May
take without
regard to
food
Antaci
ds,
days (IDSA)
Ophthalmic
o
See
Conjuncti
vitis
Otic
o
See
Otitis
Externa
Epididymitis
(likely caused by
urinary tract
pathogens) - 300mg
(CDC)
Pelvic
inflammatory disease
- 400mg twice a day for
10 - 14 days (PI)
Pneumonia,
community-acquired 400mg twice a day for
10 days (PI)
Prostatitis due
to E. coli - 300mg twice
a day for 6 weeks (PI)
Salmonella,
twice a day for 5 -7 days
(IDSA)
Shigella - 300mg
(IDSA)
Skin infections,
uncomplicated 400mg twice a day for
10 days (PI)
Urinary tract
infection due to E.
coli or K. pneumoniae
3 days (IDSA, PI)
Urinary tract
infection due to other
pathogens - 200mg
(PI)
Urinary tract
infections,
complicated - 200mg
(PI)
sucralfate,
metal
cations (e.g.
iron), and
multivitamin
s may
reduce
ofloxacin
absorption.
Do not take
within 2
hours of
each other.
o
Kidney
disease CrCl 20 50ml - usual
dose every
24 hours;
CrCl <
20ml/min half the
usual dose
every 24
hours
SULFA MEDICATIONS
Medicatio
Dosage Form
n
Sulfametho Tablet
xazole(sulfa/tmp)
trimethopri
o
800/1
m
60mg
(double
(Septra)
strength)
(Bactrim)
($)
o
400/8
0mg (single
strength)
($)
Suspension
(sulfa/tmp)
o
200m
g/40mg/5ml
($)
Dosing
Pediatric
NOTE: All pediatric dosing
based on trimethoprim
component
o
Cellulitis (MRSA
coverage) - 8
12mg/kg/day given in 2
days (IDSA)
Cyclospora 5mg/kg/day (max
divided doses for 3
days (CTE)
Once daily 8mg/kg/day (max

320mg/day)
given once daily
for 5 days
Twice daily
- 8mg/kg/day
(max 320mg/day)
given in two
divided doses for
3 days
May
be taken
without
regard to
food
May
cause
photosensiti
vity. Use
sunscreen,
etc.
Trimet
hoprim may
raise
potassium
levels in
susceptible
patients
Trimet
hoprim is a
CYP2C8
inhibitor
Trimet
hoprim is
an OCT2
inhibitor
and
substrate
Sulfa
methoxazol
e is a Weak
CYP2C9
inhibitor
Kidne
y disease CrCL >
30ml/min no dose
adjustment
necessary;
CrCl 15 - 30
- use half
the usual
Impetigo
Other
(Dosi
ng based
on PMID
25172376)
Salmonella,
nontyphoidal 10mg/kg/day (max
days (IDSA)
Shigella 10mg/kg/day (max
divided doses for 3
days (IDSA)
Urinary tract
days (CTE)
Urinary tract
infection,
prophylaxis 3mg/kg/day (max
daily (CTE)
Adolescents and adults

o
Acne 800/160mg twice a day
(AAP)
o
Bite, animal Sulfamethoxazoletrimethoprim 800/160
twice a day +
clindamycin
300mg 3 times a
day; OR
metronidaz
ole 250 - 500mg
3 times a day
(IDSA)
Cellulitis (MRSA
coverage) - 1 - 2
double strength tablets
days (IDSA)
Cyclospora 800/160 twice a day for

7 days (IDSA)
Diabetic foot
ulcer (mild, MRSA
coverage) - 1 - 2
double strength tablets
days (IDSA)
Diverticulitis Sulfamethoxazoletrimethoprim 800/160

twice a day +
metronidazole 500mg 3
dose; CrCl
< 15
ml/min - do
not use
- 4 times a day for 7 14 days (CTE)

o
E.Coli,
enterotoxigenic 800/160 twice a day for
3 days (IDSA)
Prostatitis,
acute - 800/160mg
weeks (CTE)
Prostatitis,
chronic - 800/160mg
weeks (CTE)
Pyelonephritis 800/160mg twice a day

for 14 days; If this
regimen is used
empirically,
then also give
one time dose (IDSA)
Salmonella,
nontyphoidal 800/160 twice a day for
5 -7 days (IDSA)
Shigella 800/160 twice a day for

3 days (IDSA)
Urinary tract
infection - 800/160
(as long as local
resistance rates do not
exceed 20%) (IDSA)
Urinary tract
infection,
prophylaxis
Postcoital 200/40mg one

time postcoital
(CTE)
Continuous
- 200/40mg once
daily OR
200/40mg three
times a week
(CTE)
TETRACYCLINES
Medicatio
Dosage Form
Dosing
n
Doxycyclin Monohydrate Pediatric ( 8 years old)
e
o
Pneumonia,
Monohydra
community-acquired,
te and
Capsule
atypical - 2 Hyclate
o
50m
4mg/kg/day given in 2
g, 100mg
(Acticlate
($)
days (IDSA)
)
o
40m
(Vibramyci
g, 75mg,
n)
150mg ($ Adolescents and adults
(Doryx)
o
Acne - 50 $$-$$$$)
150mg once daily or 50
- 100mg twice a day
Tablet
(AAP)
o
50m
o
Bite, animal g, 75mg,
100mg twice a day
100mg ($)
(IDSA)
o
150
o
Bite, human mg ($$$-$
100mg twice a day
$$$)
(IDSA)
Suspension
o
25m
g/5ml ($-$
$)
Cellulitis (MRSA
coverage) - 100mg
twice a day 5 - 10 days
(IDSA)
Chlamydia 100mg twice a day for

7 days (CDC)
Diabetic foot
ulcer (mild, MRSA
coverage) - 100mg
days (IDSA)
Hyclate
Capsule
o
50m
g, 100mg
($-$$)
20m
g
Capsule enteric coated

o
75m
g, 100mg
($$-$$$)
Other
o
May be
taken
without
regard to
food
Take
with full
glass of
water to
reduce risk
of
esophageal
irritation
Dairy
products do
not affect
doxycycline
absorption
Conco
mitant use of
tetracyclines
and
isotretinoin
has been
associated
with
pseudotumor
cerebri.
Concurrent
use should
be avoided.
May
cause
photosensitiv
ity. Use
sunscreen,
etc.
Antaci
ds may
decrease
Epididymitis
(likely caused by
chlamydia or
gonorrhea)
Doxycycline
- 100mg twice a
day for 10 days +
Ceftriaxone
250mg IM single
dose (CDC)
Gonorrhea
Tablet
o
o
20m
g ($)
100
mg ($-$$)
Tablet - enteric
coated
(Doryx)
o
75m
g, 100mg,
150mg ($
$$-$$$$)
o
80m
g, 200mg
Tablet
(Acticlate)
o
75m
g, 150mg
($$$$)
Doxycycline
- 100mg twice a
day for 7 days +
Ceftriaxone
250mg IM single
dose (CDC)
bioavailabilit
y of
doxycycline.
Do not take
within 4
hours of
each other.
Doxycycline
- 100mg twice a
day for 7 days +
Cefixime 400mg
single dose (CDC)
Pneumonia,
community-acquired
7 - 14 days (IDSA, CTE)
[3,4]
Prostatitis,
chronic - 100mg twice
a day for 4 - 6 weeks
(CTE)

7 days (IDSA, PI)
Syphilis
(primary and
secondary, penallergic) - 100mg twice
a day for 14 days (CDC)
Syphilis (latent,
pen-allergic) - 100mg
(CDC)
Adolescents and adults standard-release
o
Acne - 50 100mg once daily or 50
- 100mg twice a day
(AAP)
o
Cellulitis (MRSA
coverage) - 100mg
twice a day 5 - 10 days
(IDSA)
Doxycy
cline should
not be used
in children <
8 years old
because of
possible
tooth
discoloration
Kidney
disease - no
dose
adjustment
necessary
May be
taken
without
regard to
food
Dairy
products do
not affect
minocycline
absorption
Minocyclin Capsule
e
o
50m
g, 75mg,
(Minocin)
100mg ($)
(Dynacin
)
(Solodyn) Tablet
o
50m
g, 75mg,
100mg ($
$$-$$$$)
Adolescents and adults Tablet,

extended-release tablets
extendedo
Acne release
1mg/kg/day (max
o
45m
g, 90mg,
daily (PI)
115mg,
135mg ($
$-$$$$)
Tablet,
extendedrelease
(Solodyn)
o
55m
g, 65mg,
80mg,
105mg,
115mg ($
$$$)
Take
with full
glass of
water to
reduce risk
of
esophageal
irritation
Antaci
ds may
decrease
bioavailabilit
y of
minocycline.
Do not take
within 4
hours of
each other.
May
cause
photosensitiv
ity. Use
sunscreen,
etc.
Conco
mitant use of
tetracyclines
and
isotretinoin
has been
associated
with
pseudotumor
cerebri.
Concurrent
use should
be avoided.
May
cause
hyperpigmen
tation around
scars, shins,
and mucous
membranes
with
prolonged
use
Minocy
cline should
not be used
in children <
8 years old
because of
possible
tooth
discoloration
o
Tetracyclin Capsule
Adolescents and adults
e
o
250
o
Acne - 500mg
mg ($)
twice a day (AAP)
(Achromyci
o
500
o
Syphilis
n V)
mg ($$$-$
(primary and
$$$)
secondary, penallergic) - 500mg 4
o
100
times a day for 14 days
(CDC)
mg
o
Kidney
disease - has
not been
studied.
Manufacturer
makes no
specific
recommenda
tion.
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
Antaci
ds may
decrease
bioavailabilit
y of
tetracycline.
Do not take
within 4
hours of
each other.
Syphilis (latent,
pen-allergic) - 500mg
4 times a day for 28
days (CDC)
May
cause
photosensitiv
ity. Use
sunscreen,
etc.
Conco
mitant use of
tetracyclines
and
isotretinoin
has been
associated
with
pseudotumor
cerebri.
Concurrent
use should
be avoided.
Tetracy
cline should
not be used
in children <
8 years old
because of
possible
tooth
discoloration
Kidney
disease dose
reduction
recommende
d.
Manufacturer
makes no
specific
recommenda
tion.
RECOMMENDATION SOURCE
o
o
AAP - American Academy of Pediatrics recommendation

ACG - American College of Gastroenterology recommendation
AHA - American Heart Association recommendation
CDC - Center for Disease Control recommendation
PI - Dosing from Package Insert
IDSA - Infectious Disease Society of America recommendation
CTE - dosing based on clinical trial(s) and/or expert opinion
PRICING
o
o
$ = 0 - $50
$$ = $51 - $100
$$$ = $101 - $150
$$$$ = > $151
o
o
Pricing based on a standard course of therapy in a child and adult

Pricing based on survey of GoodRX.com, HEB, and Costco,
[accessed 6/2014]
Pricing may vary by region and availability
References:
1 - PMID 24918220
2 - PMID 8666093
3 - PMID 20456738 Doxy trial in CAP
4 - PMID 9989538 Doxy trial in CAP
http://id.wikipedia.org/wiki/Eritromisin
Eritromisin
Dari Wikipedia bahasa Indonesia, ensiklopedia bebas
Belum Diperiksa
Artikel ini perlu dirapikan agar memenuhi standar Wikipedia
Merapikan artikel bisa berupa membagi artikel ke dalam paragraf atau wikifikasi artikel. Setelah dirapikan, tolong
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Eritromisin merupakan antibiotik golongan makrolid. Antibiotika golongan makrolida mempunyai

persamaan yaitu terdapatnya cincin lakton yang besar dalam rumus molekulnya.
1. ASAL DAN KIMIA Eritromisin dihasilkan oleh suatu strain Streptomyces erythreus. Zat ini berupa
kristal berwarna kekuningan, larut dalam air sebanyak 2 mg/ml. Eritromisin larut lebih baik dalam etanol
atau pelarut organik. Antibiotik ini tidak stabil dalam suasana asam, kurang stabil pada suhu kamar tetapi
cukup stabil pada suhu rendah. Aktivitas in vitro paling besar dalam suasana alkalis. Larutan netral
eritromisin yang disimpan pada suhu kamar akan menurun potensinya dalam beberapa hari, tetapi bila
disimpan pada suhu 5 biasanya tahan sampai beberapa minggu.
2. AKTIVITAS MIKROBA Golongan makrolid menghambat sintesis protein kuman dengan jalan
berikatan secara reversible dengan ribosom subunit 50S, dan bersifat bakteriostatik atau bakterisid
tergantung dari jenis kuman dan kadarnya. Spektrum antimikroba. In vitro, efek terbesar eritromisin
terhadap kokus gram positif, seperti Str. Pyogenes dan Str. Pneumoniae. Str. Viridans mempunyai
kepekaan yang bervariasi terhadap eritromisin. S. aureus yang resisten terhadap eritromisin serin dijumpai
di rumah sakit (strain nosokmial). Batang gram positif yang pka terhadap eritromisin ialah Cl.
Perfringens, C. Diphtheriae, dan L. monocytogenes. Eritromisin tidak aktif terhadap kebanyakan kuman
gram negatif, namun ada beberapa spesies yang sangat peka terhadap eritromisin yaitu N. Gonorrhoeae,
Campylobacter jejuni, M. Pneumoniae, Legionella pneumophila, dan C. Trachomatis. H. Influenzae
mempunyai kepekaan yang bervariasi terhadap obat ini.
3. RESISTENSI Resistensi terhadap eritromisin terjadi melalui 3 mekanisme yang diperantarai oleh
plasmid yaitu : 1.Menurunnya permeabilitas dinding sel kuman, 2.Berubahnya reseptor obat pada ribosom
kuman, dan 3.Hidrolisis obat oleh esterase yang dihasilkan oleh kuman tertentu (Enterobacteriaceae)
4.FARMAKOKINETIK 1.Pemberian Eritromisin basa dihancurkan oleh asam lambung sehingga obat ini
diberikan dalam bentuk tablet salut enterik atau ester. Semua obat ini diabsorpsi secara adekuat setelah
pemberian per-oral. 2.Distribusi Distribusi eritromisin ke seluruh cairan tubuh baik kecuali ke cairan
sebrospinal. Obat ini merupakan satu di antara sedikit antibiotika yang bedifusi ke dalam cairan prostat da
mempunyai sifat akumulasi unit ke dalam makrofag. Obat ini berkumpul di hati. Adanya inflamasi
menyebabkan penetrasinya ke jaringan lebih baik. 3.Metabolisme Eritromisin dimetabolisme secara
ekstensif dan diketahui menghambat oksidasi sejumlah obat melalui interaksinya dengan sistemsitokrom
P-450. 4.Ekskresi Eritromisin terutama dikumpulkan dan diekskresikan dalam bentuk aktif dalam
empedu. Reabsorpsi parsial terjadi melalui sirkulasi enterohepatik.
5.EFEK SAMPING 1.Gangguan epigastrik Efek samping ini paling sering dan dapat mengakibatkan
ketidakpatuhan pasien terhadap eritromisin. 2.Ikterus Kolestatik Efek samping ini terjadi terutama pada
eritromisin estolat. Reaksi ini timbul pada hari ke 10-20 setelah dimulainya terapi. Gejalanya berupa nyeri
perut yang menyerupai nyeri pada kolestasis akut, mual, muntah, kemudian timbul ikterus, demam,
leukositosis dan eosinofilia; transaminase serum dan kadar bilirubin meninggi; kolesitogram tidak
menunjukkan kelainan. 3.Ototoksisitas Ketulian sementara berkaitan dengan eritromisin terutama dalam
dosis tinggi. 4.Reaksi Alergi Reaksi alergi mungkin timbul dalam bentuk demam, eosinofilia dan
eksantem yang cepat hilang bila terapi dihentikan.
6.INTERAKSI OBAT 1.Eritromisin dengan obat asma (turunan teofilin) Efek obat asma dapat meningkat.
Obat asma digunakan untuk membuka jalan udara paru-paru dan untuk mempermudah pernapasan
penderita asma. Akibatnya : terjadi efek samping merugikan karena terlalu banyak obat asma. Gejala
yang dlaporkan : mual, salit kepala, pusing, mudah terangsang, tremor, insomnia, aritmia jantung,
takhikardia, dan kemungkinan kejang. 2.Eritromisin dengan Karbamazepin Efek karbamazepin dapat
meningkat. Karbamazepin adalah antikonvulsan yang digunakan untuk mengendalikan kejang pada
gangguan seperti ayan. Akibatnya : terjadi efek samping merugikan yang disebabkan karena terlalu
banyak karbamazepin. Gejala yang dilaporkan : pusing, mual, nyeri perut, dan nanar. 3.Eritromisin
dengan Digoksin Efek digoksin meningkat. Digoksin digunakan untuk layu jantung dan untuk
menormalkan kembali denyut jantung yang tak teratur. Akibatnya : terjadi fek samping merugikan karena
terlalu banyak digoksin. Gejala yang dilaporkan : mual, kehilangan nafsu makan, aritmia jantung,
takhikardia atau bradikardia. 4.Erirtromisin dengan Klindamisin atau Linkomisin Efek antibiotika
klindamisin dan linkomisin dapat berkurang. Akibatnya : infeksi yang diobati mungkin tidak sembuh
seperti yang diharapkan. 5.Erirtromisin dengan Antibiotika penisilin Efek masing-masing antibiotika
dapat meningkat atau berkurang. Karena akibatnya sulit diramalkan, sebaiknya kombinasi ini dihindari.
7.SEDIAAN DAN POSOLOGI Tabel Posologi eritromisin Preparat Kemasan Posologi/ cara pemberian
Keterangan Eritromisin Kapsul/tablet 250 mg dan 500 mg Dewasa : 1-2 g/hari, dibagi dalam 4 dosis
Anak : 30-50 mg/kg berat badan sehari dibagi dalam 4 dosis Dosis dapat ditingkatkan 2x lipat pada
infeksi berat Obat diberikan sebelum makan Eritromisin stearat Kapsul 250 mg dan tablet 500 mg
Suspensi oral mengandung 250 mg/5 ml Dewasa : 250-500 mg tiap 6 jam atau 500 mg tiap 12 jam Anak :
30-50 mg/kg berat badn sehari dibagi dalam beberapa dosis Idem Eritromisin etilsuksinat Tablet kunyah
200 mg Suspensi oral mengandung 200 mg/5 ml dalam botol 60 ml Tetes oral mengandung 100 mg/2,5
ml dalam botol 30 ml Dewasa : 400-800 mg tiap 6 jam atau 800 m tiap 12 jam Anak: 30-50 mg/kg berat
badan sehari dibagi dalam beberapa dosis Obat tidak perlu diberikan sebelum makan
8.PENGGUNAAN KLINIK 1.Infeksi Mycoplasma pneumoniae Eritromisin yang diberikan 4 kali 500
mg sehari per oral mempercepat turunnya panas dan mempercepat penyembuhan sakit. 2.Penyakit
Legionnaire Eritromisin merupakan obat yang dianjurkan untuk pneumonia yang disebabakan oleh
Legionella pneumophila. Dosis oral ialah 4 kali 0,5-1 g sehari atau secara intravena 1-4 g sehari. 3.Infeksi
Klamidia Eritromisin merupakan alternatif tetrasiklin untuk infeksi klamidia tanpa komplikasi yang
menyerang uretra, endoserviks, rektum atau epididimis. Dosisnya ialah 4 kali sehari 500 mg per oral yang
diberikan selama 7 hari. Eritromisin merupakan obat terpilih untu wanita hamil dan anak-anak dengan
infeksi klamidia. 4.Difteri Eritromisin sangat efektif untuk membasmi kuman difteri baik pada infeksi
akut maupun pada carrier state. Perlu dicatat bahwa eritromisin maupun antibiotika lain tidak
mempengaruhi perjalanan penyakit pada infeksi akut dan komplikasinya. Dalam hal ini yang penting
antitoksin. 5.Infeksi streptokokus Faringitis, scarlet fever dan erisipelas oleh Str. Pyogenes dapat diatasi
dengan pemberian eritromisin per oral dengan dosis 30 mg/kg BB/hari selama 10 hari. Pneumonia oleh
pneumokokus juga dapat diobati secara memuaskan dengan dosis 4 kali sehari 250-500 mg. 6.Infeksi
stapilokokus Eritromisin merupakan alternatif penisilin untuk infeksi ringan oleh S. Aureus (termasuk
strain yang resisten terhadap penisilin). Tetapi munculnya strain-strain yang resisten telah mengurangi
manfaat obat ini. Untuk infeksi berat oleh stafilokokus yang resisten terhadap penisilin lebih efektif bila
digunakan penisilin yang tahan penisilinase (misalnya dikloksasilin atau flkloksasilin) atau sefalosporin.
Dosis eritromisin untuk infeksi stafilokokus pada kulit atau luka ialah 4 kali 500 mg sehar yang diberikan
selama 7-10 hari per oral. 7.Infeksi Campylobacter Gastroenteritis oleh Campylobacter jejuni dapat
diobati dengan eritromisin per oral 4 kali 250 mg sehari. Dewasa ini fluorokuinolon telah menggantikan
peran eritromisin untuk infeksi ini. 8.Tetanus Eritromisin per oral 4 kali 500 mg sehari selama 10 hari
dapat membasmi Cl. tetani pada penderita tetanus yan alergi terhadap penisilin. Antitoksin, obat kejang
dan pembersih luka merupakan tindakan lain yang sangat penting. 9.Sifilis Untuk penderita sifilis stadium
diniyang alergi terhadap penisilin, dapat diberikan eritromisin per oral dengan dosis 2-4 g sehari selama
10-15 hari. 10.Gonore Eritromisin mungkin bermanfaat untuk gonore diseminata pada wanita hamil yang
alergi tehadap penisilin. Dosis yang diberikan ialah 4 kali 500 mg sehari yang diberika selama 5 hari per
oral. Angka relaps hampir mencapai 25 % 11.Penggunaan profilaksis Obat terbaik untuk mencegah
kambuhnya demam reumatik ialah penisilin. Sulfonamid dan eritromisin dapat dipakai bila penderita
alergi terhadap penisilin. Eritromisin juga dapat dipakai sebagai pengganti penisilin untuk penderita
endokarditis bakterial yang akan dicabut giginya. Dosis eritromisin untuk keperluan ini ialah 1 g per oral
yang diberikan 1 jam sebelum dilakukan tindakan, dilanjutkan dengan dosis tunggal 500 mg yang
diberikan 6 jam kemudian. 12.Pertusis Bila diberikan pada awal infeksi, eritromisin dapat mempercepat
penyembuhan.
9.NAMA DAGANG DIPASARAN 1.Aknemycin 2.Arsitrosin 3.Bannthrocin 4.Cetathrocin 5.Corsatrocin
6.Decathrocin 7.Erira 8.Eritromec 9.Erphatrocine 10.Erybiotic 11.Erycoat forte 12.Eryderm 13.Erymed
14.Erymed plus 15.Eryprima 16.Erysanbe 17.Erythrin 18.Erythrocin 19.Erythrocin E.E.S 20.Hoprin
21.Jeracin 22.Kemothrocin 23.Konithrocin 24.Medoxin 25.Opithrocin 26.Pharothrocin 27.Rythron

28.Tamaret 29.Throcidan 30.Tromilin 31.Zapphire
DAFTAR PUSTAKA
1. Ganiswara, G, Suliatia, dkk., 1995., Farmakologi Dan Terapi Edisi ke-4., Fakultas Kedokteran UI.,
Jakarta., 675-678 2. J. Mycek, Mary, dkk., 2001., Farmakologi Ulasan Bergambar Edisi ke-2., Widya
Medika., Jakarta., 321-323 3. Harkness, Richard., 1984., Interaksi Obat., ITB., Bandung., 210-211 4.
Ikatan Sarjana Farmasi Indonesia., ISO., Jakarta., 501
http://en.wikipedia.org/wiki/Cefixime
Cefixime is an antibiotic useful for the treatment of a number of bacterial infections. It is a third
generation cephalosporin developed by Wyeth Pharmaceuticals. It is on the World Health Organization's
List of Essential Medicines, a list of the most important medication needed in a basic health system.[1]
Contents
1 Medical uses
o 1.1 Spectrum of bacterial susceptibility
2 Mechanism of action
3 Contraindications
4 Adverse effects
5 Drug Interactions
6 History
7 Trade Names
8 References
Medical uses
Cefixime treats infections of the:
Ear: Otitis caused by Haemophilus influenzae, Moraxella catarrhalis and Streptococcus pyogenes.
Sinuses: Sinusitis.
Throat: Tonsillitis, pharyngitis caused by Streptococcus pyogenes.
Chest and lungs: Bronchitis, pneumonia caused by Streptococcus pneumoniae and Haemophilus
influenzae.
It is also used to treat typhoid fever
Spectrum of bacterial susceptibility
Cefixime is a broad spectrum cephalosporin antibiotic and is commonly used to treat bacterial infections
of the ear, urinary tract, and upper respiratory tract. The following represents MIC susceptibility data for a
few medically significant microorganisms:[2]
Escherichia coli: 0.015 g/mL - 4 g/mL

Haemophilus influenzae: 0.004 g/mL - >4 g/mL
Proteus mirabilis: 0.008 g/mL - 0.06 g/mL
Mechanism of action
The bactericidal action of Cefixime is due to the inhibition of cell wall synthesis. It binds to one of the
penicillin binding proteins (PBPs) which inhibits the final transpeptidation step of the peptidoglycan
synthesis in the bacterial cell wall, thus inhibiting biosynthesis and arresting cell wall assembly resulting
in bacterial cell death.
Absorption
Only 40-50% is absorbed from the GI tract (oral). Rate may be decreased if taken with food. Absorption
from oral suspensions than tablet is more.
Distribution
It has high concentrations in bile and urine. It can cross the placenta and its protein binding capacity is
65%.
It is always better to perform appropriate cultures and susceptibility studies to determine the causative
organism and its sensitivity to cefixime.
Contraindications
Cefixime is contraindicated in patients with known sensitivity or allergies to cephalosporin class of
antibiotics. As Cefixime is a third generation cephalosporin, it is not contraindicated for patients with a
true penicillin allergy.[3]
Adverse effects
Adverse drug reactions include diarrhea, dyspepsia, nausea and vomiting. Hypersensitivity reactions like
skin rashes, urticaria and Stevens-Johnson syndrome have been reported. There is no specific antidote for
Cefixime overdosage. Gastric lavage may performed. Dialysis will not remove Cefixime in significant
quantities.
Drug Interactions
Alcohol - No major interaction has been observed between cefixime and alcohol. [4]
History
It was sold under the trade name Suprax 125 in the USA until 2003 when it was taken off the market by
drug manufacturer Wyeth after its patent expired.
Trade Names
Trade names include:
Ofex (Delta Pharma Ltd. Bangladesh)

Taxim-O (Alkem Laboratories Limited, India)
C-3 (Astra Biopharmaceuticals Ltd. Bangladesh)
References
1. "WHO Model List of EssentialMedicines" (PDF). World Health Organization. October
2013. Retrieved 22 April 2014.
2. http://www.toku-e.com/Assets/MIC/Cefixime%20trihydrate.pdf
3. http://www.cks.nhs.uk/gonorrhoea/prescribing_information/prescribing_information/ce
phalosporins_ceftriaxone_or_cefixime
4. http://www.nhs.uk/conditions/gonorrhoea/pages/MedicineOverview.aspx?
condition=Bacterial%20infections&medicine=Cefixime&preparationCefixime
%20100mg/5ml%20oral%20suspension
http://www.kerjanya.net/faq/11193-cefixime.html
INDIKASI DAN KONTRAINDIKASI

Cefixime merupakan obat golongan cephalosporin generasi ketiga dengan aktivitas luas untuk melawan
bakteri gram-negatif. Mekanisme kerja cefixime adalah dengan berikatan dengan 1 atau lebih protein
pengikat penicillin, menahan sintesis dinding sel bakteri dan menghambat pertumbuhan bakteri.
Cefixime dapat digunakan antara lain untuk bronkitis akut dan eksaserbasi akut dari bronkitis kronis yang
disebabkan oleh Streptococcus pneumoniae dan Heamophilus influenza, otitis media (infeksi telinga
tengah) yang disebabkan oleh Haemophilus influenza dan Streptococcus pyogenes, faringitis (peradangan
faring) dan tonsilitis (peradangan tonsil) yang disebabkan oleh Streptococcus pyogenes, infeksi saluran
kemih tanpa komplikasi yang disebabkan oleh Escherichia coli dan Proteus mirabilis, gonorrhea (kencing
nanah) tanpa komplikasi, hingga demam tifoid.
Cefixime tidak boleh digunakan pada orang yang memiliki riwayat hipersensitifitas atau alergi terhadap
cefixime. Penggunaan cefixime harus menjadi perhatian pada orang-orang dengan gangguan ginjal yang
berat, memiliki riwayat alergi terhadap antibiotik golongan penicillin, gizi buruk, serta wanita hamil dan
menyusui.
EFEK SAMPING
Diare merupakan efek samping yang angka kejadiannya lebih dari 10% pada pengguna cefixime. Selain
diare, terdapat berbagai efek samping yang dapat terjadi pada orang yang mengonsumsi cefixime, seperti
syok, reaksi alergi (pada orang yang sebelumnya belum pernah mengonsumsi cefixime), perubahan
hematologi, peningkatan uji fungsi hati, gangguan ginjal, bahkan gangguan respirasi.
DOSIS
Cefixime merupakan antibiotik yang penggunaannya harus dilakukan dengan resep dokter. Penggunaan
cefixime untuk mengobati infeksi akibat bakteri seperti penyakit bronkitis, otitis media, faringitis atau
tonsilitis, serta infeksi saluran kemih bisa digunakan sekali minum 400 mg per hari atau dibagi 2 dosis
dalam sehari untuk 514 hari. Sementara itu, penggunaan cefixime untuk orang dengan kencing nanah
cukup sekali minum 400 mg (dosis tunggal) dan ditambah dengan antibiotik lain, seperti azithromcin 1
gram dosis tunggal atau doxycycline 100 mg dibagi 2 dosis selama 7 hari.
Cefixime tersedia dalam bentuk kapsul 200 mg, 100 mg, dan 50 mg dan sirup kering 100 mg/5 ml.
BACA JUGA
Cari : cefixime kapsul 100 mg

Keputihan saat hamil
uspensi oral atau tablet pada anak-anak> 12 tahun atau berat> 50 kg: 400 mg sekali
sehari atau 200 mg setiap 12 jam selama 10-14 hari.
Otitis Media Akut (AOM)
Oral:
suspensi oral pada anak 6 bulan sampai 12 tahun: 8 mg / kgBB sekali sehari atau 4 mg /
kgBB setiap 12 jam selama 10-14 hari.
Suspensi oral pada anak-anak> 12 tahun atau berat> 50 kg: 400 mg sehari selama 10-14
hari.
Jangan gunakan tablet untuk pengobatan AOM.
Faringitis dan Tonsilitis
Oral: suspensi oral pada anak 6 bulan sampai 12 tahun: 8 mg / kgBB sekali sehari atau 4
mg / kgBB setiap 12 jam untuk 10 hari.
Suspensi oral atau tablet pada anak-anak> 12 tahun atau berat> 50 kg: 400 mg sekali
sehari atau 200 mg setiap 12 jam untuk 10 hari.
Infeksi Saluran Kemih (ISK)
> ISK Terkomplikasi (UTI)
Oral:
Suspensi oral pada anak 6 bulan sampai 12 tahun: 8 mg / kgBB sekali sehari atau 4 mg /
kgBB setiap 12 jam untuk 5-10 hari.
sehari atau 200 mg setiap 12 jam untuk 5-10 hari.
Gonore dan Infeksi Associated
> Tanpa komplikasi uretra, endoserviks, atau rektal Gonore
Oral:
suspensi oral (200 mg / 5 ml) atau tablet pada remaja: 400 mg sebagai dosis tunggal,
> Diseminata Infeksi gonokokus
Oral:
Suspensi oral (200 mg / 5 ml) atau tablet pada remaja: 400 mg dua kali sehari
direkomendasikan oleh CDC; diberikan untuk menyelesaikan pengobatan 1 minggu
setelah rejimen awal ceftriaxone parenteral atau sebaliknya, sefotaksim atau spectinomycin
Salmonella dan Shigella Infeksi
> Demam Tifoid
Oral:
Anak-anak 6 bulan sampai 16 tahun: 5-10 mg / kgBB dua kali sehari. Biasanya diberikan
selama 14 hari, tingginya tingkat kegagalan pengobatan terjadi jika diberikan hanya 7 hari.
> Shigellosis
Oral:
8 mg / kgBB sehari selama 5 hari.
Untuk membaca link selanjutnya klik link Cefixime bagian 2

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http://obat-drug.blogspot.com/2014/09/cefixeme-sefiksim-bagian-1.html
CEFIXIME (SEFIKSIM) BAGIAN 1
OBAT CEFIXIME (SISTEMIK) SEFIKSIM

Antibakteri; Antibiotik -laktam; Sefalosporin generasi ketiga.
KELAS:
Sefalosporin Generasi Ketiga
MEREK DAGANG CEFIXIME (SEFIKSIM):

Cefspan, Ceptik, Comsporin, Fixacef, Fixep, Fixiphar, Lanfix, Maxpro, Simcef, Sofix, Spancef,
Spaxim, Sarcef, Tocef, Urticef, Trixim, Taxime, Suprax, Opixime, Sopime, Fixiphar, Cefilia,
Maxipime, Sofix,Sporetik, Nucef, Lanfix.
NAMA GENERIK :
Cefixime
MEKANISME AKSI CEFIXIME (SEFIKSIM)

Menghambat sintesis dinding sel bakteri dengan berikatan pada satu atau lebih ikatan
protein - penisilin (penicillin-binding proteins-PBPs) yang selanjutnya akan menghambat
tahap transpeptidasi sintesis peptidoglikan dinding sel bakteri sehingga menghambat
biosintesis dinding sel. Bakteri akan mengalami lisis karena aktivitas enzim autolitik
(autolisin dan murein hidrolase) saat dinding sel bakteri terhambat.
Berdasarkan spektrum aktivitas, diklasifikasikan sebagai cephalosporin.3 generasi ketiga,
spektrum aktivitas lebih luas terhadap bakteri gram negatif dibandingkan dengan
sefalosporin generasi pertama dan kedua, kurang aktif terhadap Enterobacteriaceae
daripada beberapa cephalosporins generasi ketiga lainnya.
Biasanya bactericidal.
Spektrum aktivitas mencakup banyak bakteri gram positif dan gram negatif aerobik, tidak
aktif terhadap semua bacteria anaerob, aktif terhadap klamidia, jamur, dan virus..
NAMA KIMIA:
[6R-[6,7(Z)]]-7-[[(2-Amino-4-thiazoyl)[(carboxymethoxy)imino]acetyl]amino]-3-ethenyl-8oxo-5-thia-1-azabicyclo[4.2.0]oct-2-ene-2- Asam karboksilat
C16H15N5O7S2,3H2O
SIFAT FISIKA KIMIA CEFIXIME (SEFIKSIM)

Serbuk putih atau hampir berwarna putih, agak higroskopik, sulit larut dalam air, sedikit
larut dalam alkohol dehidrasi, praktis tidak larut dalam etil asetat, mudah larut dalam metil
alkohol. pH 5%larutan dalam air : 2.6 - 4.1.
PENGGUNAAN / FUNGSI / INDIKASI CEFIXIME
Infeksi Saluran Pernapasan

Pengobatan bronkitis akut yang disebabkan oleh Streptococcus pneumoniae, Haemophilus
influenzae (termasuk bakteri yang memproduksi -laktamase), atau Moraxella catarrhalis.
Pengobatan eksaserbasi akut bronkitis kronis yang disebabkan oleh S. pneumoniae, H.
influenza (termasuk bakteri yang memproduksi -laktamase), atau M. catarrhalis.
Pengobatan Pneumonia Komuniti (CAP) ringan sampai sedang yang disebabkan oleh
S. pneumoniae, H. influenzae, M. catarrhalis, E. coli, H. parahaemolyticus,
atau H. parainfluenzae.
Pengobatan sinusitis ringan sampai sedang yang disebabkan oleh S. pneumoniae, H.
influenzae, M. catarrhalis, E. coli, H. parahaemolyticus, atau H. parainfluenzae.
Pengobatan AOM disebabkan oleh H. influenzae (termasuk strain yang memproduksi laktamase), M. catarrhalis (termasuk strain yang memproduksi -laktamase), atau S.
pyogenes (Streptococci -hemolytic kelompok A).

Pengobatan faringitis dan tonsilitis yang disebabkan oleh S. pyogenes sensitive
(Streptokokus -hemolytic grup A). Umumnya efektif dalam pemberantasan S. pyogenes
dari nasofaring, tetapi keberhasilan dalam pencegahan demam rematik berikutnya belum
ditentukan.
CDC, AAP, IDSA, AHA, dan lainnya merekomendasikan penisilin V oral atau penisilin G
benzatin IM sebagai pengobatan pilihan. Sefalosporin oral dan makrolida oral
dipertimbangkan sebagai terapi alternatif. Amoksisilin kadang-kadang digunakan sebagai
pengganti penisilin V, terutama untuk anak anak.
Infeksi Saluran Kemih (ISK) / UTI (Urinary Tract Infection)
Pengobatan tanpa UTIs / ISK komplikasi disebabkan oleh Escherichia rentan coli atau
mirabilis Proteus, juga telah digunakan untuk pengobatan ISK tanpa komplikasi yang
disebabkan oleh Citrobacter spp rentan, C. Diversus, C. freundii, Enterobacter spp., E.
aerogenes, E. agglomerans, Klebsiella spp., K. pneumoniae, Morganella morganii, Proteus
spp., atau Serratia.
Telah digunakan untuk pengobatan UTIs / ISK tanpa komplikasi disebabkan oleh bakteri
gram positif rentan, termasuk Staphylococcus epidermidis, Staphylococcus spp
Streptococcus agalactiae, streptokokus nonhemolitik, atau Enterococcus faecalis.
Pertimbangkan bahwa kegagalan pengobatan telah dilaporkan dan bakteri gram positif
(misalnya, staphylococci, S. agalactiae, enterococci) telah diisolasi dalam urin selama atau
setelah pengobatan cefixime dan biasanya tahan (resisten) terhadap cefixime.
Pengobatan pielonefritis dan UTIs
Enterobacteriaceae, termasuk E. coli.
ISK
rumit
lainnya,
disebabkan
oleh
rentan

Pengobatan uretra uncompicated, endoserviks, atau infeksi dubur yang disebabkan oleh
Neisseria gonorrhoeae rentan. CDC merekomendasikan ceftriaxone atau sefiksim sebagai
obat pilihan untuk serviks uncomplicated, uretra, atau gonore dubur pada dewasa dan
remaja, Ceftriaxone direkomendasikan untuk gonorrhea faring.
Tindak lanjut pengobatan infeksi gonokokal luas setelah rejimen parenteral awal
(ceftriaxone atau alternative, sefotaksim, atau spektinomisin; CDC merekomendasikan
cefixime atau cefpodoxime sebagai obat pilihan untuk pengobatan tindak lanjut.
Infeksi Salmonella dan Shigella

Telah digunakan untuk pengobatan demam tifoid (demam enterik) atau septikemia yang
disebabkan oleh resisten Salmonella typhi.
Telah digunakan untuk pengobatan shigellosis yang disebabkan oleh rentan Shigella.
Penyakit Lyme
Telah digunakan untuk pengobatan Penyakit Lyme menyebar. Sefalosporin lain (sefotaksim,
seftriakson, cefuroxime axetil) biasanya dianjurkan oleh IDSA dan lainyan ketika
cephalosporin yang digunakan dalam pengobatan Penyakit Lyme.
DOSIS DAN ADMINISTRASI CEFIXIME

ADMINISTRASI / RUTE PEMBERIAN CEFIXIME
Administrasi Oral
Berikan secara oral
Rekonstitusi
Rekonstitusi suspense oral ketika obat akan diberikan ke pasien dengan menambahkan
sejumlah air sesuai ketentuan pada wadah dalam dua bagian. Membalikkan botol dan
kocok setelah setiap penambahan. Suspensi mengandung 100 atau 200 mg / 5 mL.
Kocok suspensi oral sesaat sebelum pemberian setiap dosis.
DOSIS CEFIXIME (SEFIKSIM)
Tersedia sebagai cefixime trihidrat; Dosis dinyatakan dalam cefixime.
Pasien Pediatric
Infeksi Saluran Pernapasan
> Bronkitis Akut
Oral:
> Eksaserbasi akut dari bronkitis kronis
Oral:
Oral:
Suspensi oral pada anak-anak> 12 tahun atau berat> 50 kg: 400 mg sehari selama 10-14
hari.
Jangan gunakan tablet untuk pengobatan AOM.

Oral: suspensi oral pada anak 6 bulan sampai 12 tahun: 8 mg / kgBB sekali sehari atau 4
mg / kgBB setiap 12 jam untuk 10 hari.
sehari atau 200 mg setiap 12 jam untuk 10 hari.
Infeksi Saluran Kemih (ISK)
> ISK Terkomplikasi (UTI)
Oral:
kgBB setiap 12 jam untuk 5-10 hari.
sehari atau 200 mg setiap 12 jam untuk 5-10 hari.
> Tanpa komplikasi uretra, endoserviks, atau rektal Gonore
Oral:
suspensi oral (200 mg / 5 ml) atau tablet pada remaja: 400 mg sebagai dosis tunggal,
> Diseminata Infeksi gonokokus
Oral:
Suspensi oral (200 mg / 5 ml) atau tablet pada remaja: 400 mg dua kali sehari
direkomendasikan oleh CDC; diberikan untuk menyelesaikan pengobatan 1 minggu
setelah rejimen awal ceftriaxone parenteral atau sebaliknya, sefotaksim atau spectinomycin
Salmonella dan Shigella Infeksi
> Demam Tifoid
Oral:
Anak-anak 6 bulan sampai 16 tahun: 5-10 mg / kgBB dua kali sehari. Biasanya diberikan
selama 14 hari, tingginya tingkat kegagalan pengobatan terjadi jika diberikan hanya 7 hari.
> Shigellosis
Oral:
8 mg / kgBB sehari selama 5 hari.

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Peni Sulfa medications

Strep throat 1000mg/day given

Strep throat 300mg twice a day for

divided doses for 5 - 10

Adolescents and Adults

Sinusitis 200mg twice a day for

Strep throat 100mg twice a day for

Sinusitis - 15 30mg/kg/day (max

Strep throat 15g/kg/day (max

Adolescents and Adults

Otitis media 50mg/kg/day (max

Shigella 50mg/kg/day IM/IV

Gonorrhea Ceftriaxone 250mg IM

Sinusitis 30mg/kg/day given in

Strep throat 20mg/kg/day given in

Adolescents and Adults

Gonorrhea 1000mg one time dose

Sinusitis 250mg twice a day for

250mg twice a day for

Otitis media 75 - 100mg/kg/day

Strep throat 40mg/kg/day (max

Adults (15 years and

Impetigo 250mg 4 times a day

Strep throat 500mg twice a day for

Postcoital 250mg one time

before procedure (penicillin

Impetigo 20mg/kg/day (max

Sinusitis - 8 12mg/kg/day divided into 3

Strep throat 7mg/kg/dose 3 times daily

Clindamycin oral 300mg twice a day for

Bite, animal Clindamycin - 300mg 3 times

Diabetic foot ulcer

Diabetic foot ulcer

Impetigo - 300 - 400

Strep throat - 300mg

May take without

Mix packet with 3

Kidney disease clearance is decreased.

< 45kg 10mg/kg (max 500mg)

> 45kg - 500mg

minutes before procedure

Shigella 10mg/kg/day (max

Strep throat 12mg/kg/day (max 500

Vibrio vulnificus 10mg/kg/day (max

Campylobacter 500mg once daily for 3 days

Azithromycin 500mg on Day 1

Extendedrelease (Zmax) 2000mg one time

Prostatitis, chronic 500mg once daily for 4 - 6

once daily for 3 days (CTE)

Strep throat - 500mg

Vibrio vulnificus 500mg once daily for 3 days

Strep throat 15mg/kg/day (max

prophylaxis - 500mg 30 60 minutes before

Amoxicillin 1000mg twice a day;

Metronidazole 500mg twice a day

Extendedrelease - 1000mg once

Prostatitis, chronic 500mg twice a day for 4 - 6

Extendedrelease - 1000mg once

Skin infections 250mg twice a day for 7 - 14

Strep throat - 250mg

H. pylori Metronidazole - 20mg/kg/day

Amoxicillin 50mg/kg/day (max