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Penicillin's:
Ampicillin:
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Use Treatment of susceptible bacterial infections (nonbeta-lactamase-producing organisms); susceptible bacterial infections caused by streptococci, pneumococci, nonpenicillinase-producing staphylococci, Listeria , meningococci; some strains of H. influenzae , Salmonella , Shigella , E. coli , Enterobacter , and Klebsiella Mechanism of Action Inhibits bacterial cell wall synthesis by binding to one or more of the penicillin binding proteins (PBPs); which in turn inhibits the final transpeptidation step of peptidoglycan synthesis in bacterial cell walls, thus inhibiting cell wall biosynthesis. Bacteria eventually lyse due to ongoing activity of cell wall autolytic enzymes (autolysins and murein hydrolases) while cell wall assembly is arrested -------------------------------- Dosing: Infants and Children: Mild-to-moderate infections: I.M., I.V.: 100-150 mg/kg/day in divided doses every 6 hours (maximum: 2-4 g/day) . Oral: 50-100 mg/kg/day in doses divided every 6 hours (maximum: 2-4 g/day) . Severe infections/meningitis: I.M., I.V.: 200-400 mg/kg/day in divided doses every 6 hours (maximum: 6-12 g/day) Endocarditis prophylaxis: I.M., I.V.: Dental, oral, respiratory tract, or esophageal procedures: 50 mg/kg within 30 minutes prior to procedure in patients unable to take oral amoxicillin Genitourinary and gastrointestinal tract (except esophageal) procedures: High-risk patients: 50 mg/kg (maximum: 2 g) within 30 minutes prior to procedure, followed by ampicillin 25 mg/kg (or amoxicillin 25 mg/kg orally) 6 hours later; must be used in combination with gentamicin. Moderate-risk patients: 50 mg/kg within 30 minutes prior to procedure -------------------------------- Adults: Susceptible infections: Oral: 250-500 mg every 6 hours I.M., I.V.: 250-500 mg every 6 hours Sepsis/meningitis: I.M., I.V.: 150-250 mg/kg/24 hours divided every 3-4 hours (range: 6-12 g/day) Endocarditis prophylaxis: I.M., I.V.: Dental, oral, respiratory tract, or esophageal procedures: 2 g within 30 minutes prior to procedure in patients unable to take oral amoxicillin Genitourinary and gastrointestinal tract (except esophageal) procedures: High-risk patients: 2 g within 30 minutes prior to procedure, followed by ampicillin 1 g (or amoxicillin 1 g orally) 6 hours later; must be used in combination with gentamicin Moderate-risk patients: 2 g within 30 minutes prior to procedure -------------------------------- Renal Dosing: [CRCL >50]: no change. [30-49]: q6-8 hours. [10-29]: q8-12 hours. [<10 ]: q12-24 hours.Hemodialysis: [<10 ml/min]: Give usual dose every 12-24 hours. Schedule dose after dialysis on dialysis days. -------------------------------- Supplied: Capsule (Principen®): 250 mg, 500 mg Injection, powder for reconstitution, as sodium: 125 mg, 250 mg, 500 mg, 1 g, 2 g, 10 g Powder for oral suspension (Principen®): 125 mg/5 mL (100 mL, 200 mL); 250 mg/5 mL (100 mL, 200 mL) |
Ampicillin/ sulbactam: (Unasyn ®)
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Use Treatment of susceptible bacterial infections involved with skin and skin structure, intra-abdominal infections, gynecological infections; spectrum is that of ampicillin plus organisms producing beta-lactamases such as S. aureus , H. influenzae , E. coli , Klebsiella , Acinetobacter , Enterobacter , and anaerobes ----------------------------- Dosing: Children >/= 1 year: I.V.: Mild-to-moderate infections: 100-150 mg ampicillin/kg/day (150-300 mg Unasyn®) divided every 6 hours; maximum: 8 g ampicillin/day (12 g Unasyn®) Severe infections: 200-400 mg ampicillin/kg/day divided every 6 hours; maximum: 8 g ampicillin/day (12 g Unasyn®) Adults: I.M., I.V.: 1-2 g ampicillin (1.5-3 g Unasyn®) every 6 hours; maximum: 8 g ampicillin/day (12 g Unasyn®) ----------------------------- Renal Dosing: [CRCL >30]: 1.5-3.0 grams q6-8h [15-30]: 1.5-3.0 grams q12h. [5-14 ]: 1.5-3.0 grams q24 hours. Hemodialysis: 1.5-3.0 grams q24 hours – give dose after dialysis when patient is being dialyzed. PD: 1.5-3.0 grams q24 hours -------------------------------- Supplied: Injection, powder for reconstitution: 3 g [ampicillin sodium 2 g and sulbactam sodium 1 g]; 15 g [ampicillin sodium 10 g and sulbactam sodium 5 g] [bulk package] Unasyn®: 1.5 g [ampicillin sodium 1 g and sulbactam sodium 0.5 g]; 3 g [ampicillin sodium 2 g and sulbactam sodium 1 g]; 15 g [ampicillin sodium 10 g and sulbactam sodium 5 g] [bulk package] |
Amoxicillin:
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Use Treatment of otitis media, sinusitis, and infections caused by susceptible organisms involving the respiratory tract, skin, and urinary tract; prophylaxis of bacterial endocarditis in patients undergoing surgical or dental procedures; as part of a multidrug regimen for H. pylori eradication ----------------------------- Dosing: Oral: Children </= 3 months: 20-30 mg/kg/day divided every 12 hours. Children: >3 months and <40 kg: Dosing range: 20-50 mg/kg/day in divided doses every 8-12 hours. Ear, nose, throat, genitourinary tract, or skin/skin structure infections: Mild to moderate: 25 mg/kg/day in divided doses every 12 hours or 20 mg/kg/day in divided doses every 8 hours Severe: 45 mg/kg/day in divided doses every 12 hours or 40 mg/kg/day in divided doses every 8 hours Acute otitis media due to highly-resistant strains of S. pneumoniae: Doses as high as 80-90 mg/kg/day divided every 12 hours have been used Lower respiratory tract infections: 45 mg/kg/day in divided doses every 12 hours or 40 mg/kg/day in divided doses every 8 hours Subacute bacterial endocarditis prophylaxis: 50 mg/kg 1 hour before procedure ----------------------------- Adults: Dosing range: 250-500 mg every 8 hours or 500-875 mg twice daily; maximum dose: 2-3 g/day Ear, nose, throat, genitourinary tract or skin/skin structure infections: Mild to moderate: 500 mg every 12 hours or 250 mg every 8 hours. Severe: 875 mg every 12 hours or 500 mg every 8 hours. Lower respiratory tract infections: 875 mg every 12 hours or 500 mg every 8 hours. Endocarditis prophylaxis: 2 g 1 hour before procedure. Helicobacter pylori eradication: 1000 mg twice daily; requires combination therapy with at least one other antibiotic and an acid-suppressing agent (proton pump inhibitor or H2 blocker) -------------------------------- Renal Dosing: [CRCL >30 ]: No change. [10-29 ml/min]: q8-12h. Do not use 875 mg tablet. [<10 ml/min]: q24h. Do not use 875mg tablet. Hemodialysis: 250-500mg q24h plus additional dose after dialysis. -------------------------------- Supplied: Capsule, as trihydrate: 250 mg, 500 mg Tablet, as trihydrate [film coated] (Amoxil®): 500 mg, 875 mg Tablet, chewable, as trihydrate: 125 mg, 200 mg, 250 mg, 400 mg Powder for oral suspension, as trihydrate: 125 mg/5 mL (80 mL, 100 mL, 150 mL); 200 mg/5 mL (50 mL, 75 mL, 100 mL); 250 mg/5 mL (80 mL, 100 mL, 150 mL); 400 mg/5 mL (50 mL, 75 mL, 100 mL) Powder for oral suspension, as trihydrate [drops] (Amoxil®): 50 mg/mL (15 mL [DSC], 30 mL) [bubble gum flavor] |
Amoxicillin/ Clavulanate (Augmentin ®)
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Use Treatment of otitis media, sinusitis, and infections caused by susceptible organisms involving the lower respiratory tract, skin and skin structure, and urinary tract; spectrum same as amoxicillin with additional coverage of beta-lactamase producing B. catarrhalis , H. influenzae , N. gonorrhoeae , and S. aureus (not MRSA). The expanded coverage of this combination makes it a useful alternative when amoxicillin resistance is present and patients cannot tolerate alternative treatments. ----------------------------- Dosing: Children >/= 3 months and <40 kg: Otitis media: 90 mg/kg/day divided every 12 hours for 10 days Lower respiratory tract infections, severe infections, sinusitis: 45 mg/kg/day divided every 12 hours or 40 mg/kg/day divided every 8 hours. Less severe infections: 25 mg/kg/day divided every 12 hours or 20 mg/kg/day divided every 8 hours ----------------------------- Children >40 kg and Adults: 250-500 mg every 8 hours or 875 mg every 12 hours ----------------------------- Children >/= 16 years and Adults: Acute bacterial sinusitis: Extended release tablet: Two 1000 mg tablets every 12 hours for 10 days CCommunity-acquired pneumonia: Extended release tablet: Two 1000 mg tablets every 12 hours for 7-10 days -------------------------------- Renal Dosing: [CRCL >30 ]: no change . [10-30 ]: 250-500 mg q12h. Do not use the 875 mg tablet. [<10 ml/min]: 250-500 mg q24h. Do not use the 875 mg tablet. Hemodialysis: 250-500 mg q24h. Give additional dose after dialysis. -------------------------------- Supplied: Powder for oral suspension: Augmentin®: 125: Amoxicillin 125 mg and clavulanate potassium 31.25 mg per 5 mL (75 mL, 100 mL, 150 mL) [banana flavor] 200: Amoxicillin 200 mg and clavulanate potassium 28.5 mg per 5 mL (50 mL, 75 mL, 100 mL) [contains phenylalanine 7 mg/5 mL; orange-raspberry flavor] 250: Amoxicillin 250 mg and clavulanate potassium 62.5 mg per 5 mL (75 mL, 100 mL, 150 mL) [orange flavor] 400: Amoxicillin 400 mg and clavulanate potassium 57 mg per 5 mL (50 mL, 75 mL, 100 mL) [contains phenylalanine 7 mg/5 mL; orange-raspberry flavor] Augmentin ES-600®: Amoxicillin 600 mg and clavulanic potassium 42.9 mg per 5 mL (75 mL, 125 mL, 200 mL) [contains phenylalanine 7 mg/5 mL; orange flavor] Tablet: Augmentin®: 250: Amoxicillin trihydrate 250 mg and clavulanate potassium 125 mg 500: Amoxicillin trihydrate 500 mg and clavulanate potassium 125 mg 875: Amoxicillin trihydrate 875 mg and clavulanate potassium 125 mg Tablet, chewable: Augmentin®: 125: Amoxicillin trihydrate 125 mg and clavulanate potassium 31.25 mg 200: Amoxicillin trihydrate 200 mg and clavulanate potassium 28.5 mg 250: Amoxicillin trihydrate 250 mg and clavulanate potassium 62.5 mg 400: Amoxicillin trihydrate 400 mg and clavulanate potassium 57 mg Tablet, extended release (Augmentin XR™): Amoxicillin 1000 mg and clavulanic acid 62.5 mg |
Cloxacillin (Tegopen ®)
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Use Treatment of susceptible bacterial infections, notably penicillinase-producing staphylococci causing respiratory tract, skin and skin structure, bone and joint, urinary tract infections ---------------------------- Dosing: (Should be taken 1 hour before or 2 hours after meals with water. ) Oral: Children >1 month (<20 kg): 50-100 mg/kg/day in divided doses every 6 hours; up to a maximum of 4 g/day Children (>20 kg) and Adults: 250-500 mg every 6 hours -------------------------------- Renal Dosing: No adjustments needed -------------------------------- Supplied: Capsule, as sodium: 250 mg, 500 mg Powder for oral suspension, as sodium: 125 mg/5 mL (100 mL, 200 mL) |
Dicloxacillin (Dynapen ®)
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Use Treatment of systemic infections such as pneumonia, skin and soft tissue infections, and osteomyelitis caused by penicillinase-producing staphylococci --------------------------- Dosing: Oral: Use in newborns not recommended Children <40 kg: 12.5-25 mg/kg/day divided every 6 hours; doses of 50-100 mg/kg/day in divided doses every 6 hours have been used for therapy of osteomyelitis Children >40 kg and Adults: 125-250 mg every 6 hours -------------------------------- Renal Dosing: No adjustments needed. -------------------------------- Supplied: Capsule: 250 mg, 500 mg |
Nafcillin
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Use Treatment of infections such as osteomyelitis, septicemia, endocarditis, and CNS infections caused by susceptible strains of staphylococci species --------------------------- Dosing:: Children: I.M.: 25 mg/kg twice daily I.V.: Mild to moderate infections: 50-100 mg/kg/day in divided doses every 6 hours Severe infections: 100-200 mg/kg/day in divided doses every 4-6 hours Maximum dose: 12 g/day Adults: I.M.: 500 mg every 4-6 hours I.V.: 500-2000 mg every 4-6 hours -------------------------------- Renal Dosing: No adjustment in renal failure -------------------------------- Supplied:: Infusion [premixed iso-osmotic dextrose solution]: 1 g (50 mL); 2 g (100 mL) Injection, powder for reconstitution, as sodium: 1 g, 2 g, 10 g |
Penicillin G
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Use Active against some gram-positive organisms, generally not Staphylococcus aureus ; some gram-negative organisms such as Neisseria gonorrhoeae , and some anaerobes and spirochetes --------------------------- Dosing: I.M., I.V.: Infants: <7 days, <2000 g: 50,000 units/kg/day in divided doses every 12 hours <7 days, >2000 g: 50,000 units/kg/day in divided doses every 8 hours >7 days, <2000 g: 75,000 units/kg/day in divided doses every 8 hours >7 days, >2000 g: 100,000 units/kg/day in divided doses every 6 hours --------------------------- Infants and Children (sodium salt is preferred in children): 100,000-250,000 units/kg/day in divided doses every 4 hours Severe infections: Up to 400,000 units/kg/day in divided doses every 4 hours; maximum dose: 24 million units/day Congenital syphilis: Newborns: 50,000 units/kg/day I.V. every 8-12 hours for 10-14 days Infants: 50,000 units/kg every 4-6 hours for 10-14 days DDisseminated gonococcal infections or gonococcus ophthalmia (if organism proven sensitive): 100,000 units/kg/day in 2 equal doses (4 equal doses/day for infants >1 week) Gonococcal meningitis: 150,000 units/kg in 2 equal doses (4 doses/day for infants >1 week) --------------------------- Adults: 2-24 million units/day in divided doses every 4 hours depending on sensitivity of the organism and severity of the infection Neurosyphilis: 18-24 million units/day in divided doses every 3-4 hours for 10-14 days -------------------------------- Renal Dosing: [CRCL >50] Normal dose. [10-50]: Give 75% of usual dose q4-6h. [<10 ]: Give 20-50% of usual dose q4-6h. Hemo: 500,000 - 800,000 units q6h or Give 20-50% of usual dose q4-6h. -------------------------------- Supplied:: Infusion, as potassium [premixed iso-osmotic dextrose solution, frozen]: 1 million units (50 mL), 2 million units (50 mL), 3 million units (50 mL) Injection, powder for reconstitution, as potassium (Pfizerpen®): 5 million units, 20 million units Injection, powder for reconstitution, as sodium: 5 million units |
Penicillin VK
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Dosing: Adults (Usual): 250-500mg po q6h. --------------------------- Dosing: Oral: Systemic infections: Children <12 years: 25-50 mg/kg/day in divided doses every 6-8 hours; maximum dose: 3 g/day. Children >/= 12 years and Adults: 125-500 mg every 6-8 hours. Prophylaxis of pneumococcal infections: Children <5 years: 125 mg twice daily. Children >/= 5 years and Adults: 250 mg twice daily. Prophylaxis of recurrent rheumatic fever: Children <5 years: 125 mg twice daily Children >/= 5 years and Adults: 250 mg twice daily --------------------------- Renal Dosing: [CRCL > 10] no changes. Dosing interval in renal impairment: Clcr<10 mL/minute: Administer 250 mg every 6 hours -------------------------------- Supplied: 250 mg = 400,000 units Powder for oral solution: 125 mg/5 mL (100 mL, 200 mL); 250 mg/5 mL (100 mL, 200 mL) Tablet: 250 mg, 500 mg |
Piperacillin (Pipracil ®)
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No longer available. Use: Treatment of susceptible infections such as septicemia, acute and chronic respiratory tract infections, skin and soft tissue infections, and urinary tract infections due to susceptible strains of Pseudomonas , Proteus , and Escherichia coli and Enterobacter ; active against some streptococci and some anaerobic bacteria; febrile neutropenia (as part of combination regimen) Dosing: Infants and Children: I.M., I.V.: 200-300 mg/kg/day in divided doses every 4-6 hours Higher doses have been used in cystic fibrosis: 350-500 mg/kg/day in divided doses every 4-6 hours Adults: I.M., I.V.: Moderate infections (urinary tract infections): 2-3 g/dose every 6-12 hours; maximum: 2 g I.M./site Serious infections: 3-4 g/dose every 4-6 hours; maximum: 24 g/24 hours Uncomplicated gonorrhea: 2 g I.M. in a single dose accompanied by 1 g probenecid 30 minutes prior to injection --------------------------- Renal Dosing: [>40 ml/min]: No changes. [20-40]: 3-4 grams q8h. [<20 ]: 4 grams q12h. Hemo: Manufacturer: 2 grams IV q8h + 1 gram additional dose after each dialysis -------------------------------- Supplied: Injection, powder for reconstitution: 2 g, 3 g, 4 g, 40 g |
Piperacillin/ Tazobactam (Zosyn ®)
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Indications: Treatment of infections caused
by susceptible organisms, including infections of the lower respiratory
tract (community-acquired pneumonia, nosocomial pneumonia); urinary
tract; skin and skin structures; gynecologic (endometritis, pelvic
inflammatory disease); bone and joint infections; intra-abdominal
infections (appendicitis with rupture/abscess, peritonitis); and
septicemia. Tazobactam expands activity of piperacillin to include beta-lactamase
producing strains of S. aureus , H. influenzae , Bacteroides , and other
gram-negative bacteria. --------------------------- Dosing: Children >12 years and Adults: Nosocomial pneumonia: I.V.: Piperacillin/tazobactam 4/0.5 g every 6 hours for 7-14 days (when used empirically, combination with an aminoglycoside is recommended; consider discontinuation of aminoglycoside if P. aeruginosa is not isolated) Severe infections: I.V.: Piperacillin/tazobactam 4/0.5 g every 8 hours or 3/0.375 g every 6 hours for 7-10 days Moderate infections: I.M.: Piperacillin/tazobactam 2/0.25 g every 6-8 hours; treatment should be continued for >/= 7-10 days depending on severity of disease ( Note: I.M. route not FDA-approved) --------------------------- Renal Dosing: [40-90 ml/min]: 3.375 grams q6h. [20-40]: 2.25 gm q6h. [<20]: 2.25 grams q8h. Hemo: 2.25 grams q8h. Plus 0.75 g Zosyn should be administered following each dialysis period. PD: 2.25 grams q8h. -------------------------------- Supplied: 8:1 ratio of piperacillin sodium/tazobactam sodium: Infusion [premixed iso-osmotic solution, frozen]: 2.25 g: Piperacillin 2 g and tazobactam 0.25 g (50 mL) 3.375 g: Piperacillin 3 g and tazobactam 0.375 g (50 mL) 4.5 g: Piperacillin 4 g and tazobactam 0.5 g (50 mL) Injection, powder for reconstitution: 2.25 g: Piperacillin 2 g and tazobactam 0.25 g 3.375 g: Piperacillin 3 g and tazobactam 0.375 g 4.5 g: Piperacillin 4 g and tazobactam 0.5 g 40.5 g: Piperacillin 36 g and tazobactam 4.5 g |
Ticarcillin
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Dosing:
Adults: I.M., I.V.: 1 to 4 g every 4 to 6 hours, usual dose: 3 g I.V. every 4 to 6 hours -------------------------------- Renal Dosing: [>60 ml/min]: No change. [30-60]: 2 grams q4h. [10-30]: 2 grams q8h. [<10]: 1-2 grams q12h. Hemo: 2 grams q12h + supplemental dose (2-3 grams) after dialysis. -------------------------------- Supplied: Injection, powder for reconstitution, as disodium: 3 g, 20 g |
Ticarcillin/ Clavulanate (Timentin ®)
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Use Treatment of infections of lower respiratory tract, urinary tract, skin and skin structures, bone and joint, and septicemia caused by susceptible organisms. Clavulanate expands activity of ticarcillin to include beta-lactamase producing strains of S. aureus , H. influenzae , Bacteroides species, and some other gram-negative bacilli -------------------------------- Dosing: I.V.: Children and Adults <60 kg: 200-300 mg of ticarcillin component/kg/day in divided doses every 4-6 hours Children >60 kg and Adults: 3.1 g (ticarcillin 3 g plus clavulanic acid 0.1 g) every 4-6 hours; maximum: 24 g/day Urinary tract infections: 3.1 g every 6-8 hours -------------------------------- Renal Dosing: [>60 ml/min]: no change. [30-60]: 2 gm q4h or 3.1gm q8h. [10-30]: 2 gm q8h or 3.1 gm q12h. [<10]: 2 grams q12h. [<10 + hepatic dysfcn]: 2g q24h. Hemo: 2 grams q12h + additional 3.1 g after each dialysis. PD: 3.1 grams q12h -------------------------------- Supplied: Infusion [premixed, frozen]: Ticarcillin disodium 3 g and clavulanate potassium 0.1 g (100 mL) Injection, powder for reconstitution: Ticarcillin disodium 3 g and clavulanate potassium 0.1 g (3.1 g, 31 g) |
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