I. Anti-Infective Agents Antibiotics

1 1 2018/09/10 I. Anti-Infective Agents A. Antibiotics 1. Penicillins Amoxicillin B Brand name Amoxil 25mg/cc; 60cc/bot 250mg/cap (supercillin) 500mg/cap OAMOS OAMO2 OAMO5 Indication Sinusitis, otitis media, bacterial pharyngitis. Dosage Adult: q8h-q12h. Child: 25-50mg/kg/day in divided q8h-12h. Side effect Allergy reaction, skin rash, itching. Precaution 7 Ampicillin B Brand name Ampicillin sodium500mg/vial IAMPI Indication Sinusitis, otitis media, pharyngitis. Dosage Adult: IV 50-250mg/kg/day q6h (max: 12 g/day). Child: IV 100-400mg/kg/day given q6h. Side effect skin rash, diarrhea, headache. 2 Dicloxacillin B Brand name Ziefmycin 250mg/cap ODICL Indication Sinusitis, skin and soft tissue infection, pharyngitis.

2 Dosage Child > 40kg and adults: PO 125-500mg q6h. Child < 40kg: in divided every 6 hr. Side effect: skin rash, headache, vomiting. Oxacillin sod B Brand name Ocillina 1 g/vial IOXAC Indication Sinusitis, skin and soft tissue infections. Dosage Adult(>40kg): IM or IV (10-30mins) 250mg-2g q4-6h. Child (<40kg): IM or IV (10-30mins) 50-100mg/kg/day in divided q4-6h,(max:12g/day) Side effect Mild diarrhea, skin rash, nausea. Precaution 3 Piperacillin C Brand name Picillina 2g/vial IPIP2 Indication: treatment G(-) G(+). 3 Dosage Adult: IM, IV 2-4g q4-8h. Children 12 years and Adolescents: , : Refer to adult dosing (max: 24 g daily) Penicillin G sod B Brand name Penicillin G 300 /vial IPG3 Indication Gonococcal arthritis, Listeriosis, bacterial meningitis, penumonia, pericarditis. Dosage Adult:IM,IV (>10 mins)2-24 MU/day q4-6h Infant and child : MU/kg/day q4-6h, max:24MU/day Side effect Anemia, seizure, thrombocytopenia.

3 Precaution Aminoglycosides 2. Antihistamine epinephrine, oxygen, aminophyllin, IV steroids Treatment of Anaphylaxis: 1. Epinephrine a. IM or SC 1: 1000 (1) Adult: every 5 min as necessary, titrated to effects (2)Pediatric: every 5 min as necessary, titrated to effects , , . b. : Give 4 IV( ml of a 1: 10000 solution) every 5-10 minutes or an IV infusion at 1-4mcg/min. If intravenous access is not available, the endotracheal route may be used; give (5ml of a 1: 10000 solution) down the endotracheal tube. 2. , CPR 3. , , Dopamine or Norepinephrine 4. Epinephrine , beta2-agonist, : Aerosolized beta-2 agonists a. Adult: (1) Albuterol: ,diluted to 3ml of NS, may be given continuously (2) Ipratropium: in 3ml of NS, repeat as necessary b. Pediatric: (1) Albuterol: ,diluted to 3ml of NS, may be given continuously (2) Ipratropium: in 3ml of NS, repeat as necessary 5.

4 , methylprednisolone IV 1-2mg/kg penicillin G Benzathine injectable suspension B Brand name Bicillin L-A 240 /4ml/vial IPG24 Indication Mild to moderately, severe infections caused by organism susceptible to low concentrations of penicillin G. Dosage Adult- Usual dosage range: : million 5 units as a single dose Group A streptococcal upper respiratory infection: as a single dose. Prophylaxis of recurrent rheumatic fever: 25000-50000 units/kg every 3-4 weeks. Early million units as a single dose in 2 ingection sites Child- Usual dosage range: : 25,000-50,000 units/kg as a single dose (max: million units) Group A streptococcal pharyngitis(< kg): as a single dose. Side effect Local pain, convulsions, fever, rash. Precaution Deep IM. 2. -Lactamase Inhibitors Augmentin ; AmoClav; Curam; Moxiclav B Curam Syrup : 457mg/5ml Amoxicillin trihydrate 400mg Clavulanic acid 57mg Oral suspension (Amoxicillin 250mg+Clavulanic +aspartame ) Vial: (Amoxicillin 500mg + clavulanic acid 100mg)/vial Tab: ( Amoxicillin 875 mg + Clavulanic acid 125mg)/tab : OAUGMS : OAUGMC IAUGM OAUGM 6 Indication Acute otitis media, skin & soft tissue infection.

5 Dosage PO: 1 tab bid Syrup(80mg /ml amoxicillin) 2~6yrs : ~5ml bid. 7~12yrs : 5~10ml bid. Oral suspension:(50mg /ml amoxicillin) 2~12yrs : 30~60mg/kg/day divided 3 times. <2 yrs : 30~40mg/kg/day divided 3 times Injection: Adult: IV q8h or q6h. 3 month-12y/o: IV 25mg of amoxicillin/kg q8-6h. < 3month: IV 25mg of amoxicillin /kg q12-8h . Side effect GI reaction, headache, vaginal candidiasis. Precaution 1. 7 potassium; aspartame 2. 25 C 3-4 5 C 8 Piperacillin B Contains Piperacillin 2g/vial IPIPI2 Indication Infection of lower respiratory tract, urinary tract , bone and joint infection. Dosage Adult- Usual dosage range: : 2g every 6 or 8 hours, max: 24 g daily. Child- 7 Infants : 100-300mg/kg/day, q6 or 8 hours Side effect Diarrhea, fever, constipation,. Pipe&Tazo B Contains Pipril 2g + (Pisutam)/vial ITAZO Indication Infection of lower respiratory tract, urinary tract , bone and joint infection.

6 Dosage Adult- Usual dosage range: : g every 6 hours or g every 6-8 hours; max: 18 g daily. Child- Infants 2-8 months: 80 mg of piperacillin component/kg every 8 hours Infants and Children 9 months and 40kg: 100 mg of piperacillin component/kg every 8 hours Side effect Diarrhea, fever, constipation, prolong PT. Precaution 1. Tazocin 30-40% Tazocin>30 mins 3. 24 4. Piperacillin (54 ) 8 Unasyn B Brand name Unasyn (Subacillin) (Ampicillin 1g Sulbactam ) Unasyn 375mg/tab (Ampicillin 250mg Sulbactam 125mg) IUNA15 OUNAS Indication Acute otitis media, skin & soft tissue infection. Dosage Adult: PO 1tab, tid~qid. Adult: IM, IV every 6-8 hours. (max: 8 g ampicillin daily, 12 g Unasyn ). Children and Adolescents- : 100-400 mg ampicillin/kg/day divided every 6 hours (max: 8 g ampicillin daily,12 g Unasyn ).

7 Note: The American Academy of Pediatrics recommends a dose of up to 300 mg ampicillin/kg/day for severe infection in infants >1 month of age. Precaution 1. Unasyn Ampicillin 1g Sulbactam 2. Sulbactam sodium/ampicillin sodium IM/IV 115 (5 ) 3. 1st Cephalosporins Cephalexin B Brand name Ulex 25mg/cc ; 60cc/bot (sus- pension) OKEFSB Indication Streptococcus pneu, Staphylococci, Klebsiella, 9 group A beta-hemolytic Streptococci, E coli. Dosage Adult- Oral: 250-1000 mg every 6 hours (max: 4 g/day) Children >1 year- Oral: Dosing range: 25-100 mg/kg/day in divided doses every 6-8 hours (max: 4 g/day) Side effect Diarrhea, vaginitis, anemia. Precaution 7 Cefadroxil B Brand name Cefadroxil ; Ucefa 500mg/cap OCEFAD Indication skin and soft tissue , pharyngitis, urinary tract infection. Dosage Adult- Susceptible infections: Oral: 1000-2000 mg daily in 2 divided doses Orofacial infections: Oral: 250-500 mg every 8 hours.

8 Urinary tract infections: Oral: 1 g twice daily. Children- Tonsillitis/Impetigo: Oral: 30 mg/kg/day in a single dose or divided every 12 hours. Urinary tract infections/ skin and skin structure infections (except impetigo): Oral: 30 mg/kg/day divided every 12 hours (max: 2000 mg daily) Side effect GI reaction, pseudomembranous colitis. 10 Cefazolin sod B Brand name Cefa 500mg/vial Cefa ;Stazolin 1g/vial ICEF5 ICEF1 Indication Genitourinary tract, pneumonia, biliary tract infection, bone and joint infections. Dosage Adult: IV or IM: g every 8 hours, depending on severity of infection; max: 12 g daily Children >1 month: 25-100 mg/kg/day divided every 6-8 hours; max: 6 g daily Contraindication Sensitivity to cephalosporine. Side effect Anaphylaxis, rash, diarrhea. 4. 2nd Cephalosporines Cefaclor B Brand name Keflor; Cero 250mg/cap OCEFA Indication Urinary tract infection, skin and soft tissue infection, otitis media.

9 Dosage Adult: 250-500 mg every 8 hours. Children >1 month: Dosing range: 20-40 mg/kg/day divided every 8-12 hours; max dose: 1 g/day. Contraindication Sensitivity to cephalosporine. Side effect GI reactions, pseudomembranous colitis. 11 Cefuroxime sod. B Brand name Zinacef 750mg/vial Zinnat suspension 25mg/cc 50cc/bot IZINA OZINNS Indication Lower respiratory tract infection, urinary tract infection, soft , joint infections. Dosage Adult- , q8h Severe or complicated infections: , : g every 8 hours (up to g every 6 hours in life-threatening infections). Child- IM, IV: 75-150mg/kg/day divided every 8 hrs; MAX: 6g/day. Suspension: 10mg/kg bid. Precaution 10 Cefoxitin Sodium B Brand name Lofatin 1g/vial Leifoxitin 2g/vial ILOFA : ILOFA2 Indication Lower respiratory tract infection, urinary tract infection, bone & joint infections.

10 Dosage Adult: , : 1-2 g every 6-8 hours ( injection is painful); up to 12 g daily. Child: 80-160mg/kg/day in divided doses every 4-6 hours, max dose: 1g/day. Side effect Nausea, vomiting, pseudomembranous colitis. 12 Precaution 24 5. 3rd Cephalosporins Cefixime B Brand name Cefixmycin;Cefspan 100mg/ cap OCEFI Indication Otitis media, bronchitis, bacterial pharyngitis. Dosage Adult: 400 mg daily divided every 12-24 hours Children 6 months and 45 kg: 8 mg/kg/day divided every 12-24 hours (max: 400 mg daily) Side effect Thrombocytopenia, leukopenia,headache. Cefotaxime sod B Brand name Claforan; Cetame 1g/vial ICLA1 Indication Pneumonia, life-threatening infections. Dosage Adult: IV, IM: 1-2 g every 4-12 hours, MAX: 12g/day in 3-4 divided doses. Infants and Children 1 month to 12 years <50 kg: , : 50-200 mg/kg/day in divided doses every 6-8 hours Side effect GOT, GPT, rash.