Doses Commonly Prescribed Antibiotics

8/13/2019 Doses Commonly Prescribed Antibiotics

1/13

Table 1323. USUAL DOSES OF COMMONLY PRESCRIBED ANTIBIOTICS

DRUG

ADULT DOSEPEDIATRIC

(AGE > 1 MO) DOSE

DOSE IN RENALFAILUREa (CrCl< 10 mL/min)ORAL PARENTERAL

SERIOUSINFECTIONS ORAL PARENTERAL

Aminoglycosides

Amikacin N/A 15 mg/kgIV once/day

or7.5 mg/kg q 12 h

15 mg/kgIV once/day

or7.5 mg/kg IV q 12 h

N/A 57.5 mg/kg IVq 12 h

1.52.5 mg/kg IVq 2448 h

Gentamicin N/A 57 mg/kgIV once/day

or1.7 mg/kg IV q 8 h

57 mg/kgIV once/day


0.340.51 mg/kg IVq 2448 h

For synergy witha cell wallactiveantibiotic to treatenterococcal en-docarditis causedby strains suscepti-ble to gentamicin

N/A 1 mg/kg IV q 8 h N/A N/A 1 mg/kg IV q 8 h Infectious disease con-sultation required fordosage

Dosage adjusted toachieve peak serumconcentration of34 g/mL andtrough concentration

of


2/13

For hepatic coma 13 g qid N/A N/A 0.61.75 g/m2q 6 h

or

0.41.2 g/m2q 4 h

N/A N/A

Streptomycin

For TB N/A 15 mg/kg IM q 24 h(maximum: 1.0 g/day) initially, then1.0 g 23 times/wk

N/A N/A 2040 mg/kg IMonce/day

7.5 mg/kg IMq 7296 h(maximum: 1 g)

For synergy with acell wallactiveantibiotic to treatenterococcalendocarditis

N/A 7.5 mg/kg IM q 12 h N/A N/A N/A N/A

Tobramycin N/A 57 mg/kgIV once/day

or

1.7 mg/kg IV q 8 h

57 mg/kg IVonce/day

or

1.7 mg/kg IV q 8 h


0.340.51 mg/kg IVq 2448 h

-Lactams: Cephalosporins (1st generation)

Cefadroxil 0.51 g q 12 h N/A N/A 15 mg/kg q 12 h N/A 0.5 g po q 36 h

Cefazolin N/A 12 g IV q 8 h 2 g IV q 8 h N/A 16.633.3 mg/kg IVq 8 h

12 g IVq 2448 h

Cephalexin 0.250.5 gq 6 h

N/A N/A 6.2512.5 mg/kg q 6 hor

8.016 mg/kg q 8 h

N/A 0.250.5 g poq 2448 h

Table 1323. USUAL DOSES OF COMMONLY PRESCRIBED ANTIBIOTICS(Continued)

DRUG

ADULT DOSEPEDIATRIC

(AGE > 1 MO) DOSE



Table continues on the following page.


3/13

-Lactams: Cephalosporins (2nd generation)

Cefaclorb 0.250.5 gq 8 h

N/A N/A 1020 mg/kg q 12 hor

6.613.3 mg/kg q 8 h

N/A 0.5 g po q 12 h

Cefotetan N/A 13 g IV q 12 h 23 g IVq 12 h

N/A 2040 mg/kg IVq 12 h

13 g IV q 48 h

Cefoxitin N/A 1 g IV q 8 h to 2 gIV q 4 h

2 g IV q 4 hor

3 g IV q 6 h

N/A 2733 mg/kg IV q 8 hor, for severe infec-tions, 2540 mg/kgq 6 h

0.51.0 g IVq 2448 h

Cefprozil 0.25 g q 12 hor

0.5 g q 1224 h

N/A N/A 15 mg/kg q 12 h forotitis media

N/A 0.25 g po q 1224 h

Cefuroxime 0.1250.5 gq 12 h

0.751.5 g IVq 68 h

1.5 g IV q 6 h 1015 mg/kg suspensionq 12 h

For older children:

125250 mg tabletsq 12 h

2550 mg/kg IVq 8 h

0.250.5 g po q 24 hor

0.75 g IV q 24 h

For meningitis 3 g IV q 8 h 5060 mg/kg IV q 6 h

-Lactams: Cephalosporins (3rd generation)

Cefoperazone N/A 1 g q 12 h to 2 g IVq 4 h

2 g IV q 4 h N/A 25100 mg/kg IVq 12 h

Same as adult dose

Cefotaxime N/A 1 g q 12 h to 2 g IVq 4 h

2 g IV q 4 h N/A 8.333.3 mg/kg IVq 4 h

or16.666.6 mg/kg q 6 h

12 g IV q 24 h


DRUG

ADULT DOSEPEDIATRIC

(AGE > 1 MO) DOSE





4/13

Cefpodoximec 0.10.4 g q 12 h N/A N/A 5 mg/kg q 12 h N/A 0.10.4 g po q 24 h

Ceftazidime N/A 1 g IV q 12 h to 2 gq 8 h


0.5 g IV q 2448 h

Ceftibutenb 0.4 g q 24 h N/A N/A 9 mg/kg once/day N/A 0.1 g po q 24 h

Ceftizoxime N/A 0.5 g IV q 12 h to4 g IV q 8 h


0.5 g IV q 24 h to0.51 g IV q 48 h

Ceftriaxone N/A 12 g IV q 24 h 2 g IV q 24 h N/A 5075 mg/kg IV q 24 hor

2537.5 mg/kg q 12 h

Same as adult dose

For meningitis N/A 2 g IV q 12 h 2 g IV q 12 h N/A 50 mg/kg IV q 12 h or100 mg/kg q 24 h (notto exceed 4 g/day)

Possibly a loadingdose of 100 mg/kgIV (not to exceed 4 g)at the start of therapy

2 g IV q 12 h

-Lactams: Cephalosporin (4th generation)

Cefepime N/A 12 g IV q 812 h 2 g IV q 8 h N/A 50 mg/kg IV q 812 h 0.251 g IV q 24 h

-Lactams: Penicillins

Amoxicillin 0.250.5 g q 8 hor

0.875 g q 12 h

N/A N/A 12.525 mg/kg q 12 hor

713 mg/kg q 8 h

N/A 0.250.5 g po q 24 h

For endocarditisprophylaxis

2 g for 1 dose N/A N/A 50 mg/kg 1 h beforeprocedure

N/A 2 g po for 1 dose

Amoxicillin/clavulanate

0.250.5 g q 8 hor

0.875 g q 12 h

N/A N/A If >40 kg: Adult dose N/A 0.250.5 g po q 24 h


DRUG

ADULT DOSEPEDIATRIC

(AGE > 1 MO) DOSE





5/13

Amoxicillin/clavu-lanate, ES-600

N/A N/A N/A 45 mg/kg q 12 h N/A N/A

Amoxicillin/clavu-lanate, extended-release

2 g q 12 h N/A N/A N/A N/A N/A

Ampicillin N/A 0.52.0 g IV q 46 h 2 g IV q 4 h N/A 2550 mg/kg IV q 6 h 0.52.0 g IV q 1224 h

For meningitis N/A 2 g IV q 4 h 2 g IV q 4 h N/A 50100 mg/kg IVq 6 h

2 g IV q 12 h

Ampicillin/sulbactam(3 g=2 g ampicillin+1 g sulbactam)

N/A 1.53.0 g IV q 6 h 3 g IV q 6 h N/A 2550 mg/kg IV q 6 h 1.53.0 g IV q 24 h

Dicloxacillinb 0.1250.5 g q 6 h N/A N/A 3.1256.25 mg/kg q 6 h N/A 0.1250.5 g po q 6 h

Nafcillin Rarely used 12 g IV q 4 h 2 g IV q 4 h N/A 12.525 mg/kg IVq 6 h

or

8.333.3 mg/kg q 4 h

12 g IV q 4 h

Oxacillin Rarely used 12 g IV q 4 h 2 g IV q 4 h N/A 12.525 mg/kg IVq 6 h

or8.333.3 mg/kg IVq 4 h

12 g IV q 4 h

Penicillin Gb 0.250.5 g

q 612 h(penicillin V)

14 million units IV

q 46 h

4 million units IV

q 4 h

Penicillin VK

6.2512.5 mg/kgq 8 h

6,250100,000 units/

kg IV q 6 hor4,166.666,666units/kg IV q 4 h

0.52 million units

IV q 46 h(maximum totaldaily dose: 6 millionunits/day)


DRUG

ADULT DOSEPEDIATRIC

(AGE > 1 MO) DOSE





6/13

Penicillin G ben-zathine(Bicillin

L-A)For streptococcal

pharyngitisN/A 1.2 million units IM

for 1 doseN/A N/A 25,00050,000 units/

kg IM as a single doseor

If 1 MO) DOSE





7/13

Piperacillin/tazo-bactam(2.25 g =2.0 g piperacillin +

0.25 g tazobactam)

N/A 3.375 g IV q 46 h 3.375 g IV q 4 h N/A 80 mg/kg IV q 8 h 2.25 g IV q 8 h to 4.5 gIV q 12 h

Ticarcillin(5.2 mEq Na/g)

N/A 3 g IV q 46 h 3 g IV q 4 h N/A If 1 MO) DOSE





8/13

Extended-release

for uncomplicatedcystitis

0.5 g q 24 h for

3 days

N/A N/A N/A N/A N/A

Gemifloxacin 320 mg q 24 h N/A N/A N/A N/A 160 mg po q 24 h

Levofloxacin 0.250.75 gq 24 h

0.250.75IV g q 24 h

0.75 g IV q 24 h N/A N/A 0.250.5 g po or IVq 48 h

Moxifloxacin 0.4 g q 24 h 0.4 g IV q 24 h 0.4 g IV q 24 h N/A N/A 0.4 g q 24 h po or IV

Norfloxacinb 0.4 g q 12 h N/A N/A N/A N/A 0.4 g po q 24 h

Ofloxacin 0.20.4 g q 12 h 0.4 g IV q 12 h 0.20.4 g IV q 12 h N/A N/A 0.10.2 g po or IVq 24 h

Macrolides

Azithromycin 0.5 g on day 1,then 0.25 g q24 h for 4 days

0.5 g IV q 24 h 0.5 g IV q 24 h N/A 0.5 g on day 1, then0.25 g po q 24 h for 4days or 0.5 g IV q 24 h

For nongonococcalcervicitis andurethritis

1 g for 1 dose N/A N/A N/A N/A N/A

For travelersdiarrhea

1 g for 1 dose N/A N/A 510 mg/kg for1 dose

N/A N/A

For tonsillitis orpharyngitis

N/A N/A N/A 12 mg/kg for 5 days N/A N/A

For otitis mediaor community-acquired pneumonia

N/A N/A N/A 10 mg/kg on day 1,then 5 mg/kg once/dayon days 25

N/A N/A


DRUG

ADULT DOSEPEDIATRIC

(AGE > 1 MO) DOSE





9/13Table continues on the following page.

Clarithromycin 0.250.5 g q 12 hExtended-re-lease: 1 g q 24 h

N/A N/A 7.5 mg/kg q 12 h N/A 0.250.5 g po q 24 h

Dirithromycin 0.5 g q 24 h N/A N/A N/A N/A 0.5 g po q 24 h

Erythromycinbaseb

0.250.5 gq 6 h

N/A N/A 1016.6 mg/kg q 8 hor

7.512.5 mg/kg q 6 h

N/A 0.25 g po q 6 h

Lactobionate N/A 0.51 g IV q 6 h 1 g IV q 6 h N/A 3.755.0 mg/kg IVq 6 h

0.5 g IV q 6 h

Gluceptate N/A 0.51 g IV q 6 h 1 g IV q 6 h N/A 3.755.0 mg/kg IVq 6 h 0.5 g IV q 6 h

For GI preoperativebowel preparation

1 g for3 doses

N/A N/A 20 mg/kg for 3 doses N/A N/A

Telithromycin 800 mg q 24 h N/A N/A N/A N/A 800 mg po q 24 h

Sulfonamides and trimethoprim

Sulfisoxazole 1.0 g q 6 h 25 mg/kg IV q 6 h (not

available in US)

N/A 3037.5 mg/kg q 6 h

or2025 mg/kg q 4 h

N/A 1 g po q 1224 h

Sulfamethizole 0.51 g q 68 h N/A N/A 7.511.25 mg/kg q 6 h N/A N/A

Sulfamethoxazole 1 g q 812 h N/A N/A 2530 mg/kg q 12 h N/A 1 g po q 24 h

Trimethoprim 0.1 g q 12 hor

0.2 g q 24 h

N/A N/A 2 mg/kg q 12 h for10 days for UTI

N/A 0.1 g po q 24 h

Trimethoprim/sulfamethoxazolee

0.16/0.8 g q 12 h 35 mg TMP/kg IVq 68 h

5 mg TMP/kg IVq 6 h

36 mg TMP/kgq 12 h

36 mg TMP/kg IVq 12 h

(Not recommended ifother alternatives areavailable)


DRUG

ADULT DOSE PEDIATRIC(AGE > 1 MO) DOSE




10/13

For Pneumocystisjirovecii pneumo-niae

0.32/1.6 g q 8 hfor 21 days

5 mg TMP/kg IVq 8 h for 21 days

5 mg TMP/kg IVq 68 h

56.6 mg TMP/kg q 8 hor

3.755 mg TMP/kg q 6 h

56.6 mg TMP/kg IVq 8 h

or

3.755 mg TMP/kgIV q 6 h

If essential, 5 mgTMP/kg IV q 24 h

or

1.25 mg TMP/kg IVq 6 h

Tetracyclines

Doxycycline 0.1 g q 12 h 0.1 g IV q 12 h 0.1 mg IV q 12 h Age >8 yr: 24 mg/kgq 24 h

or12 mg/kg q 12 h

Age >8 yr: 24 mg/kg IV q 24 h

or12 mg/kg IV q 12 h

0.1 g IV or po q 12 h

Minocycline 0.1 g q 12 h 0.1 g IV q 12 h 0.1 g IV q 12 h N/A N/A 0.1 g IV or po q 12 hTetracyclineb 0.250.5 g

q 6 hN/A N/A Age >8 yr: 6.2512.5

mg/kg q 6 hN/A Doxycycline used

instead

Tigecycline N/A 100 mg, then 50 mg(25 mg for severehepatic dysfunc-tion) IV q 12 hr

Same as adult dose N/A N/A Same as adult dose

OthersClindamycin 0.150.45 g

q 6 h0.6 g IV q 6 h to 0.9IV g q 8 h

0.9 g IV q 8 h 2.66.6 mg/kg q 8 hor

25 mg/kg q 6 h

6.613.2 mg/kg IVq 8 h

or510 mg/kg IV q 6 h

0.150.45 g po q 6 hor

0.60.9 g IV q 68 h

Chloramphenicol 0.251 g q 6 h 0.251.0 g IV q 6 h 1 g IV q 6 h N/A 12.518.75 mg/kgIV q 6 h

0.251.0 g IV q 6 h

For meningitis N/A 12.5 mg/kg q 6 h(maximum: 4 g/day)

12.5 mg/kg IVq 6 h (maximum:4 g/day)


12.5 mg/kg IV q 6 h(maximum: 4 g/day)

Daptomycin N/A 4 mg/kg IV q 24 h 4 mg/kg IV q 24 h N/A N/A 4 mg/kg IV q 48 h


DRUG

ADULT DOSE

PEDIATRIC

(AGE > 1 MO) DOSEDOSE IN RENALFAILUREa (CrCl< 10 mL/min)ORAL PARENTERAL




11/13

Linezolid 0.6 g q 12 h 0.6 g IV q 12 h 0.6 g IV q 12 h 10 mg/kg q 8 h 10 mg/kg IV q 8 h 0.6 g IV or po q 12 h

MetronidazoleFor anaerobic

infection7.5 mg/kg q 6 h

(not to exceed4 g/day)

7.5 mg/kg IVq 6 h (not toexceed 4 g/day)

7.5 mg/kg IVq 6 h (not toexceed 4 g/day)

7.5 mg/kg q 6 h 7.5 mg/kg IV q 6 h 3.75 mg/kg IV or poq 6 h (not to exceed2 g/day)

For trichomoniasis 2 g for 1 doseor

0.5 g q 12 h for7 days

N/A N/A N/A N/A N/A

For Clostridiumdifficileinduceddiarrhea (pseudo-membranous coli-tis)

0.5 g q 68 h for1014 days

500 mg IV q 68 h 500 mg IV q 6 h 7.5 mg/kg q 8 h 7.5 mg/kg IV q 6 h 250 mg po or IV q 8 h

For amebiasis 0.50.75 g q 8 hfor 10 days fol-

lowed by paro-momycin po0.5 g q 8 h for7 days

0.75 g IV q 8 h for10 days followed

by paromomycinpo 0.5 g q 8 h for7 days

0.75 g IV q 8 hfor 10 days

followed by paro-momycin po 0.5 g q8 h for 7 days

11.616.6 mg/kgq 8 h for 710 days

11.616.6 mg/kgIV q 8 h for 710

days

N/A

For giardiasis 0.25 g q 68 hfor 57 days

N/A N/A 5 mg/kg q 68 hfor 5 days

N/A N/A

Nitrofurantoinmacrocrystals

50100 mgq 6 h

N/A N/A 1.251.75 mg/kgq 6 h

N/A Not recommended

Nitrofurantoinmonohydrate/macrocrystals

100 mg q 12 h N/A N/A N/A N/A N/A


DRUG

ADULT DOSEPEDIATRIC

(AGE > 1 MO) DOSE





12/13

Quinupristin/

dalfopristin

N/A 7.5 mg/kg IV

q 812 h

7.5 mg/kg IV q 8 h N/A 7.5 mg/kg IV q 12 h

for complicated skinor skin structureinfection

or7.5 mg/kg q 8 h for

serious infections

7.5 mg/kg IV q 812 h

Rifampinb

For TB 0.6 g q 24 h 0.6 g IV q 24 h N/A 510 mg/kg q 12 h

or1020 mg/kg q 24 h

1020 mg/kg IV

q 24 h

0.30.6 g IV or po

q 24 h

For meningococcalexposure

0.6 g q 12 h for4 doses

N/A N/A Age 1 mo: 10 mg/kgq 12 h for 2 days

Age


13/13

Vancomycin 125 mg q 6 h(only effective

for C. difficileinduceddiarrhea

15 mg/kg q 12 h(often 1 g q 12)

15 mg/kg IV q 12 h N/A 13 mg/kg IV q 8 hor

10 mg/kg q 6 h

0.51.0 g IV q wk

For meningitis N/A 1 g IV q 8 hor

1.5 g IV q 12 hf

1 g IV q 8 hor

1.5 g IV q 12 h

N/A 15 mg/kg IV q 6 h 15 mg/kg IV q wk

a

Initial loading dose should be equivalent to the usual dose for patients with normal renal function, followed by a dose adjusted for renal failure. Dosing adjustmentsof aminoglycosides should be assisted by measuring peak (drawn 1 h after the start of a 30-min IV infusion) and trough (drawn 30 min before next dose) serum levels.bRate or extent of absorption is decreased when the drug is taken with food.cDosage should not exceed that for adults.dThese drugs are generally avoided in children.eDose is based on TMP.fIn addition, intrathecal or intraventricular vancomycin 1020 mg/day may be necessary, and dose may need to be adjusted to achieve trough CSF levels of 1020

g/mL.

N/A =not applicable; TMP =trimethoprim.


DRUG

ADULT DOSEPEDIATRIC

(AGE > 1 MO) DOSE



Copyright 2011 Merck Sharp & Dohme Corp., a subsidiary of Merck & Co., Inc., Whitehouse Station, N.J. U.S.A.

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Doses Commonly Prescribed Antibiotics