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Doxycycline (Vibramycin ®)
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Use Principally in the treatment of infections caused by susceptible Rickettsia , Chlamydia , and Mycoplasma ; alternative to mefloquine for malaria prophylaxis; treatment for syphilis, uncomplicated Neisseria gonorrhoeae , Listeria , Actinomyces israelii , and Clostridium infections in penicillin-allergic patients; used for community-acquired pneumonia and other common infections due to susceptible organisms; anthrax due to Bacillus anthracis, including inhalational anthrax (postexposure); treatment of infections caused by uncommon susceptible gram-negative and gram-positive organisms including Borrelia recurrentis , Ureaplasma urealyticum , Haemophilus ducreyi , Yersinia pestis , Francisella tularensis , Vibrio cholerae , Campylobacter fetus , Brucella spp, Bartonella bacilliformis , and Calymmatobacterium granulomatis ------------------------------------------- Dosing: Children >/= 8 years (<45 kg): Susceptible infections: Oral, I.V.: 2-5 mg/kg/day in 1-2 divided doses, not to exceed 200 mg/day ------------------------- Children >8 years (>45 kg) and Adults: Susceptible infections: Oral, I.V.: 100-200 mg/day in 1-2 divided doses ------------------------- Acute gonococcal infection (PID) in combination with another antibiotic: 100 mg every 12 hours until improved, followed by 100 mg orally twice daily to complete 14 days ------------------------- Community-acquired pneumonia: 100 mg twice daily ------------------------- Lyme disease: Oral: 100 mg twice daily for 14-21 days ------------------------- Early syphilis: 200 mg/day in divided doses for 14 days Late syphilis: 200 mg/day in divided doses for 28 days ------------------------- Uncomplicated chlamydial infections: 100 mg twice daily for >/= 7 days ------------------------- Endometritis, salpingitis, parametritis, or peritonitis: 100 mg I.V. twice daily with cefoxitin 2 g every 6 hours for 4 days and for >/= 48 hours after patient improves; then continue with oral therapy 100 mg twice daily to complete a 10- to 14-day course of therapy ------------------------- Sclerosing agent for pleural effusion injection (unlabeled use): 500 mg as a single dose in 30-50 mL of NS or SWI ------------------------- Periodontitis: Oral (Periostat®): 20 mg twice daily as an adjunct following scaling and root planing; may be administered for up to 9 months. Safety beyond 12 months of treatment and efficacy beyond 9 months of treatment have not been established. ------------------------- Adults: Anthrax: Inhalational (postexposure prophylaxis): Oral, I.V. (use oral route when possible): 100 mg every 12 hours for 60 days ( MMWR , 2001, 50:889-93); Note: Preliminary recommendation, FDA review and update is anticipated. Cutaneous (treatment): Oral: 100 mg every 12 hours for 60 days. Note: In the presence of systemic involvement, extensive edema, lesions on head/neck, refer to I.V. dosing for treatment of inhalational/gastrointestinal/oropharyngeal anthrax ------------------------- Supplied: Capsule, as hyclate: 50 mg, 100 mg Capsule, as monohydrate (Monodox®): 50 mg, 100 mg Capsule, coated pellets, as hyclate (Doryx®): 75 mg, 100 mg Injection, powder for reconstitution, as hyclate (Doxy-100®): 100 mg Powder for oral suspension, as monohydrate (Vibramycin®): 25 mg/5 mL (60 mL) Syrup, as calcium (Vibramycin®): 50 mg/5 mL (480 mL) Tablet, as hyclate: 100 mg Periostat®: 20 mg Vibra-Tabs®: 100 mg Tablet, as monohydrate (Adoxa™): 50 mg, 75 mg, 100 mg |
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Minocycline (Minocin ®)
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Use Treatment of susceptible bacterial infections of both gram-negative and gram-positive organisms; treatment of anthrax (inhalational, cutaneous, and gastrointestinal); acne; meningococcal carrier state; Rickettsial diseases (including Rocky Mountain spotted fever, Q fever); nongonococcal urethritis, gonorrhea; acute intestinal amebiasis Mechanism of Action Inhibits bacterial protein synthesis by binding with the 30S and possibly the 50S ribosomal subunit(s) of susceptible bacteria; cell wall synthesis is not affected Dosing: Children >8 years: Oral, I.V.: Initial: 4 mg/kg followed by 2 mg/kg/dose every 12 hours Adults: Infection: Oral, I.V.: 200 mg stat, 100 mg every 12 hours not to exceed 400 mg/24 hours Acne: Oral: 50 mg 1-3 times/day May be taken with food or milk. Administer with adequate fluid to decrease the risk of esophageal irritation and ulceration. Dosage adjustment in renal impairment: Consider decreasing dose or increasing dosing interval with renal impairment. Supplied: Capsule, as hydrochloride: 50 mg, 75 mg, 100 mg Dynacin®: 50 mg, 75 mg, 100 mg Capsule, pellet-filled, as hydrochloride (Minocin®): 50 mg, 100 mg Injection, powder for reconstitution, as hydrochloride (Minocin®): 100 mg Tablet, as hydrochloride (Dynacin®): 50 mg, 75 mg, 100 mg |
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Tetracycline (Achromycin ®)
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Use Treatment of susceptible bacterial infections of both gram-positive and gram-negative organisms; also infections due to Mycoplasma , Chlamydia , and Rickettsia ; indicated for acne, exacerbations of chronic bronchitis, and treatment of gonorrhea and syphilis in patients that are allergic to penicillin; as part of a multidrug regimen for H. pylori eradication to reduce the risk of duodenal ulcer recurrence Dosing: Oral: Children >8 years: 25-50 mg/kg/day in divided doses every 6 hours ---------------- Adults: 250-500 mg/dose every 6 hours Helicobacter pylori eradication: 500 mg 2-4 times/day depending on regimen; requires combination therapy with at least one other antibiotic and an acid-suppressing agent (proton pump inhibitor or H2 blocker) ---------------- Dosing interval in renal impairment: Clcr 50-80 mL/minute: Administer every 8-12 hours Clcr 10-50 mL/minute: Administer every 12-24 hours Clcr<10 mL/minute: Administer every 24 hours Dialysis: Slightly dialyzable (5% to 20%) via hemo- and peritoneal dialysis or via continuous arteriovenous or venovenous hemofiltration; no supplemental dosage necessary Dosing adjustment in hepatic impairment: Avoid use or maximum dose is 1 g/day ---------------- Administration Should be administered on an empty stomach (ie, 1 hour prior to, or 2 hours after meals) to increase total absorption. Administer at least 1-2 hours prior to, or 4 hours after antacid because aluminum and magnesium cations may chelate with tetracycline and reduce its total absorption. ---------------- Supplied: Capsule, as hydrochloride: 250 mg, 500 mg Suspension, oral, as hydrochloride (Sumycin®): 125 mg/5 mL (480 mL) [contains sodium benzoate and sodium metabisulfite; fruit flavor] Tablet, as hydrochloride (Sumycin®): 250 mg, 500 mg |
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