| Name | Usual dose | Cost (AWP unit price)* | Change in absorption with food | Pregnancy classa | Dose interval adjustment for reduced CrCl | Supplemental dose in dialysis | Major toxicity | |||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Generic | Brand | Adult | Child | >50 | 10–50 | ≤10 | HD | PD | ||||
| Amikacinc | Amikin | 15 mg/kg/d; divide q8–12h IV 10–40 mg IT q24h | 15 mg/kg/d; divide q8–12h | 250 mg/mL injection; 4 mL vial = $4.05 | n.a. | D | q8–12h | q12–48h | >48h | 2.5–3.75 mg/kg pHD | 2.5 mg/kg/d IV or 3–4 mg/2 L dialysate removed | Renal toxicity, vestibular or auditory toxicity, CNS reactions, neuromuscular blockade (rare) |
| Amoxicillin | Amoxil | 0.25–0.5 g PO q8h or 875 mg PO q12h or 1000 mg PO q12h (Helicobacter pylori) | 6.6–13.3 mg/kg PO q8h (neonate: 0–7 d, 25 mg/kg q12h; 1–4 wk 25 mg/kg q8h) | 250 mg capsule: $0.25 500 mg capsule: $0.44 875 mg tablet: $0.87 400 mg/5 mL (50 mL) oral susp: $4.85 | Decreased | B | q8h | q8–12h | q16–24h | 0.25–0.5 g | 0.25 g q12h | Allergic reactions (rare: anaphylactic), rash, diarrhea, nausea, vomiting |
| Amoxicillin–clavulanate | Augmentin | 0.25–0.5 g PO q8h 875 mg PO q12h 2000 mg PO q12h XR tablets | 6.6–13.3 mg/kg PO q8h | 250/150 mg tablet: $4.11 500/125 mg tablet: $3.78 875/125 mg tablet: $5.05 XR 1000/62.5 mg tablet: $3.87 400 mg/5 mL (50 mL) oral susp: $68.93 | Decreased | B | q8h | q12h | q12–24h | 0.25 g PO | –b | Allergic reactions (rare: anaphylactic), diarrhea, nausea, vomiting, cholestatic hepatitis |
| Ampicillin | Ampen, Omnipen | 0.5–1 g PO q8h; 1–2 g IV q4–6h | 12.5–25 mg/kg PO q8h 6.25–25 mg/kg IV q8h | 250 mg capsule: $0.22 500 mg capsule: $0.40 250 mg IV vial: $3.98 1000 mg IV vial: $8.20 | Decreased | B | q4–6h | q8h | q12–24h | 0.5–2 g | 0.25 g PO q12h or 1–4 g IV q24h | Allergic reactions (rare: anaphylactic), diarrhea, nausea, vomiting |
| Ampicillin–sulbactam | Unasyn | 1.5–3 g IV q6h | 25–50 mg/kg IV q6h | 1.5 g IV vial: $7.73 3 g IV vial: $14.60 | n.a. | B | q6–8h | q8–12h | q24h | 2 g ampicillin pHD | –b | Allergic reactions (rare: anaphylactic), diarrhea, nausea, vomiting |
| Azithromycin | Zithromax | 5 g day 1; 0.25 g days 2–5 PO | –b | 250 mg tablet: $7.78 500 mg tablet: $21.21 500 mg IV vial: $7.20 100 mg/5 mL (15 mL) oral susp: $32.93 | Decreased | B | Usual | Usual | Usual | –b | –b | GI disturbance, headache |
| Azlocillin | 2–4 g IV q4–6h | 75 mg/kg IV q6h | Data not available | n.a. | B | q4–6h | q8h | q12h | 3 g pHD | –b | Allergic reactions (rare: anaphylactic), diarrhea, nausea, vomiting | |
| Aztreonam | Azactam | 1–2 g IV q6–8h | 30–50 mg/kg q6–12h (n.a.) | 1 g IV vial: $39.50 2 g vial: $80.34 | n.a. | B | q6–8h | q12–18h | q24h | 18 first dose (60–250 mg) pHD | Usual dose (1–2 g) then usual dose at usual intervals | Rash, diarrhea, nausea, vomiting, elevated AST/ALT |
| Bacampicillin | 0.4–0.8 g PO q12h | 12.5–25 mg/kg PO q12h | Data not available | None | B | q12h | q12h | –b | –b | –b | Allergic reactions (rare: anaphylactic), diarrhea, nausea, vomiting | |
| Carbenicillin indanyl sodium | 1–2 0.382-g tabs PO q6h | 7.5–12.5 mg/kg PO q6h | Data not available | Increased | B | –b | –b | –b | –b | –b | Allergic reactions (rare: anaphylactic), diarrhea, nausea, vomiting | |
| Cefaclor | Ceclor | 0.25–0.5 PO q8h | 20–40 mg/kg/d; divide q8h PO | 250 mg capsule: $1.98 500 mg capsule: $3.89 | Decreased | B | q8h | q8h | q8h | 0.25–0.5 g | –b | Allergic reactions, GI disturbance, arthritis, serum sickness |
| Cefadroxil | Duricef | 0.5–1 g PO q12–24h | 30 mg/kg/d; divide q12h PO | 500 mg capsule: $3.72 | Decreased | B | q12–24h | 0.5 g q12–24h | 0.5 g q36h | 0.5–1 g | –b | Allergic reactions, GI disturbance |
| Cefamandole | 0.5–2 g IV q4–8h | 50–150 mg/kg/d; divide q4–8h IV | Data not available | n.a. | B | q4–8h | q8h | 0.5–1 g q12h | 0.5–1 g | –b | Thrombophlebitis with IV infusion, allergic reactions, GI disturbance | |
| Cefazolin | Ancef, Kefzol | 0.5–2 g IV q8h | 25–100 mg/kg/d; divide q6–8h IV | 500 mg IV vial: $1.30 1 g IV vial: $2.61 | n.a. | B | q8h | 0.5–1 g q8–12h | 0.5–1 g q24h | 0.25–0.5 g | –b | Allergic reactions, GI disturbance, diarrhea |
| Cefdinir | Omnicef | 300 mg PO q12h | 14 mg/kg/d PO qd divide q12–24h | 300 mg capsule: $5.10 250 mg/5 mL (60 mL): $51.01 | Minimal decrease | B | Usual | 300 mg q24h | 300 mg q24h | Not defined | Not defined | Anaphylaxis, TEN, erythema multiforme, neutropenia |
| Cefditoren | Spectracef | 400 mg PO BID | 400 mg PO BID | 400 mg capsule: $14.74 | Increased | B | 400 mg PO BID | 200 mg PO BID | 200 mg PO qd | None | –b | Anaphylaxis, leukopenia, neutropenia, thrombocytopenia |
| Cefepime | Maxipime | 0.5–2 g IV q12h | 50 mg/kg IV q8h (n.a.) | 1 g IV vial: $6.96 2 g IV vial: 11.86 | n.a. | B | 0.5–2 g IV q12h | q24h | 0.25–0.5 g q24h | Dose pHD | 0.5–2 g q48h | Nausea, diarrhea, vomiting, rash, phlebitis |
| Cefixime | Suprax | 0.4 g PO q24h | 8 mg/kg/d; divide PO q24h | 400 mg tablet: $20.16 | Decreased | B | q24h | 0.3 g q24h | q48h | None | –b | Thrombophlebitis, allergic reactions, GI disturbance |
| Cefmetazole | 2 g IV q6–12h | –b | Data not available | n.a. | B | q6–12h | q16–24h | q48h | –b | –b | Thrombophlebitis, allergic reactions, GI disturbance | |
| Cefonicid | 0.5–2 g IV q24h | –b | Data not available | n.a. | B | q24h | 4–15 mg/kg q24–48h | 3–15 mg/kg q3–5 days | None | –b | Allergic reactions, GI disturbance, hypoprothrombinemia or hemorrhage | |
| Cefoperazone | 1–2 g IV q6–12h | 25–100 mg/kg IV q12h (n.a.) | Data not available | n.a. | B | q6–12h | q6–12h | q6–12h | Dose after HD | –b | Thrombophlebitis, allergic reactions, GI disturbance | |
| Cefotaxime | Claforan | 0.5–2 g IV q8–12h; 3 g q6h for CNS | 50–200 mg/kg/d; divide IV q4–8h (neonate: 0–7 d, 50 mg/kg q12h; 1–4 wk: 50 mg/kg q6–8h) | 500 mg IV vial: $3.65 1 g IV vial: $4.36 2 g IV vial: $8.54 | n.a. | B | q8–12h | q12–24h | 0.5 g q24–48h | 0.5–2 g | –b | Thrombophlebitis, allergic reactions, GI disturbance |
| Cefotetan | Cefotan | 1–2 g IV q12h | 40–60 mg/kg/d; divide IV q12h (n.a.) | 1 g IV vial: $17.58 2 g IV vial: $25.14 | n.a. | B | q12h | q24h | q48h | 25% dose nonHD days, 50% HD | –b | Thrombophlebitis, allergic reactions, GI disturbance, hypoprothrombinemia, hemorrhage |
| Cefoxitin | Mefoxin | 1–2 g IV q6–8h | 80–160 mg/kg/d; divide IV q4–8h | 1 g IV vial: $11.22 2 g IV vial: $22.50 | n.a. | B | q6–8h | q12–24h | 0.5–1 g q12–24h | 1–2 g | –b | Thrombophlebitis, allergic reactions, GI disturbance |
| Cefpodoxime | Vantin | 0.1–0.4 g PO q12h | 5 mg/kg PO q12h | 100 mg tablet: $6.73 200 mg tablet: $8.45 | Increased | B | q12h | q24h | q24h | Dose 3 × wk | –b | Allergic reactions, GI disturbance |
| Cefprozil | Cefzil | 0.25–0.5 g PO q12–24h | 15 mg/kg PO q12h | 250 mg tablet: $4.37 500 mg tablet: $9.04 | No effect | B | q12–24h | 50% dose q12–24h | 50% dose q12–24h | –b | –b | Allergic reactions, GI disturbance |
| Ceftaroline | Teflaro | 600 mg IV q12h | −b | 600 mg IV: $59.98 | n.a. | B | q12h | 300-400 mg q12h | 200 mg q12h | None | −b | Allergic reactions, diarrhea, nausea, direct Coombs seroconversion |
| Ceftazidime | Fortaz, Tazicef, Tazidime | 1–2 g IV q8–12h | 25–50 mg/kg IV q8h | 1 g IV vial: $12.90 2 g IV vial: $18.59 | n.a. | B | q8–12h | q12–24h | q24–48h | 1 g load then 1 g pHD | 0.5 g IV q24h or 250 mg/2 L dialysate | Thrombophlebitis, allergic reactions, GI disturbance |
| Ceftibuten | Cedax | 400 mg PO q12h | 3–6 mg/kg PO q8h | 400 mg capsule: $19.19 | Increased | B | for CrCl 30: 400 mg q12–24h PO 12; for CrCl 5: 29–200 mg PO qd | for CrCl 30: 400 mg q24h PO 12; for CrCl 5: 29–200 mg PO qd | 100 mg q24h | 400 mg pHD | Seizures, anaphylaxis, TEN, Stevens–Johnson syndrome, erythema multiforme | |
| Ceftizoxime | Cefizox | 1–3 g IV q6–8h | 33–50 mg/kg IV q6–8h | No data available | n.a. | B | q6–8h | 0.25–1 g q12h | 0.5 g q24h | Dose pHD | 3 g q48h | Thrombophlebitis, allergic reactions, GI disturbance |
| Ceftriaxone | Rocephin | 0.5–2 g IV q12–24h (neonate: 0–7 d, 50 mg/kg q24h; 1–4 wk, 50–75 mg/kg q24h) | 50–100 mg/kg/d; divide IV q12–24h | 250 mg IV vial: $1.50 500 mg IV vial: $1.50 1 g IV vial: $2.64 2 g IV vial: $5.28 | n.a. | B | q12–24h | q12–24h | q12–24h | None | –b | Thrombophlebitis, allergic reactions, GI disturbance, cholelithiasis |
| Cefuroxime | Zinacef, Kefurox | 0.75–1.5 g IV q8h | 50–100 mg/kg/d divide IV q6–8h | 750 mg IV vial: $3.67 1.5 g IV vial: $13.12 | n.a. | B | q8h | q8–12h | 0.75 g q24h | 0.75 g pHD | 15 mg/kg pPD | Thrombophlebitis, allergic reactions, GI disturbance |
| Cefuroxime axetil | Ceftin | 0.125–0.5 g PO q12h | 0.125–0.25 g PO q12h | 250 mg tablet: $4.39 500 mg tablet: $8.01 | Decreased | B | q12h | q12h | 0.25 g q24h | –b | –b | Allergic reactions, GI disturbance |
| Cephalexin | Keflex, Biocef, Keftab | 0.25–1 g PO q6h | 25–100 mg/kg/d; divide PO q6h | 250 mg capsule: $0.69 500 mg capsule: $1.37 750 mg capsule: $7.69 | Unchanged | B | q6h | q8–12h | q24–48h | 0.25–1 g | –b | Allergic reactions, GI disturbance |
| Cephalothin | 0.5–2 g IV q4–6h | 80–160 mg/kg/d; divide IV q6h | Data not available | n.a. | B | q4–6h | 1–1.5 g q6h | 0.5 g q8h | 0.5–2 g | Add up to 6 mg/kg to dialysate | Thrombophlebitis with IV infusion, allergic reactions, GI disturbance | |
| Cephapirin | 0.5–2 g IV q4–6h | 40–80 mg/kg/d divide IV q6h | Data not available | n.a. | B | q4–6h | q8h | q12h | 7.5–15 mg/kg pHD then q12h | –b | Thrombophlebitis, allergic reactions, GI disturbance | |
| Cephradine | 0.25–1 g PO q6h 0.5–2 g IV q4–6h | 25–100 mg/kg/d; divide PO q6–12h 50–100 mg/kg divide IV q6h | Data not available | Decreased | B | q6h | 0.5 g q6h | 0.25 g q12h | 0.25 g before HD, then 12, 36, and 48 h pHD | 0.5 g q6h | Allergic reactions, GI disturbance | |
| Chloramphenicol | Chloromycetin | 0.25–0.75 g PO q6h 0.25–1 g IV q6h | 50–100 mg/kg/d; divide q6h PO, IV | PO: data not available 1 g IV vial: $17.00 | Vitamins may increase absorption | C | Usual | Usual | Usual | Dose pHD | Usual | Blood dyscrasias, gray baby syndrome, GI disturbance |
| Cinoxacin | 0.25 g q6h, 0.5 g PO q12h | N.R. | Data not available | Delayed absorption and lower mean peak serum levels | C | q6h | 0.25 g q12–24h | N.R. | –b | –b | Nausea, vomiting, dizziness, headache, tremors, confusion | |
| Ciprofloxacin | Cipro | 0.25–0.75 g PO q12h 0.2–0.4 g IV q12h | N.R. | 250 mg tablet: $0.31 500 mg tablet: $0.36 750 mg tablet: $0.40 | Decreased | C | q12h | 0.25–0.5 g PO q12h, IV q12–24h | 0.25–0.5 g PO q18h, IV q18–24h | 0.25–0.5 g q24h, pHD on HD days | 0.25–0.5 g q24h | Nausea, vomiting, dizziness, headache, tremors, confusion |
| Clarithromycin | Biaxin | 0.25–0.5 g PO q12h | 7.5 mg/kg q12h (n.a.) | 250 mg tablet: $4.50 500 mg tablet: $4.52 | Increased or unchanged | B | q12h | q12–24h | q24h | –b | –b | GI disturbance, abnormal taste, headache |
| Clindamycin | Cleocin | 0.15–0.3 g PO q6h 0.3–0.9 g IV q6–8h | 8–25 mg/kg/d; divide PO q6–8h 15–40 mg/kg/d; divide IV q6–8h (newborn: 0–7 d, 15 mg/kg/d q6–8h; 1–4 wk, 15–20 mg/kg/d q6–8h) | 150 mg capsule: $1.19 300 mg IV bag: $0.11 600 mg IV bag: $0.16 900 mg IV bag: $0.19 | Unchanged | B | Usual | Usual | Usual | Usual | Usual | Diarrhea, including pseudomembranous colitis, allergic reactions |
| Cloxacillin | 0.5–1 g PO q6h | 12.5–25 mg/kg PO q6h | Data not available | Decreased | B | q6h | q6h | q6h | Usual | Usual | Allergic reactions (rare: anaphylactic), diarrhea, nausea, vomiting | |
| Colistin | 5–15 mg/kg/d PO q8h 2.5–5 mg/kg/d IV q6–12h | 5–15 mg/kg/d; divide PO q8h 2.5–5 mg/kg/d; divide IV q6–12h | 150 mg IV vial: $57.00 | Not significantly absorbed orally | Not established | q6–12h | 2.5 mg/kg/d q12–24h | 1.5 mg/kg q36h | –b | –b | Nephrotoxicity, CNS side effects including confusion, coma, seizures | |
| Dapsone | 0.05–0.1 g PO q24h | 1–2 mg/kg/d; divide q24h | 25 mg tablet: $1.06 100 mg tablet: $1.30 | No effect | C | q24h | q24h | q24h | –b | –b | Rash, headache, GI irritation, infectious mono-like syndrome | |
| Daptomycin | Cubicin | 4–6 mg/kg IV q24h | Not defined | 500 mg IV vial: $382.44 | n.a. | B | 4–6 mg/kg q24h | 4–6 mg/kg q48h | 4–6 mg/kg q48h | 4–6 mg/kg q48h. Administer after dialysis session on dialysis days | 4–6 mg/kg q48h | Arrhythmias, hypersensitivity rxn, anaphlyaxis, thrombocytopenia, myopathy |
| Dicloxacillin | Dynapen | 0.25–0.5 g PO q6h | 3.125–6.25 mg/kg PO q6h | 250 mg capsule: $0.66 500 mg capsule: $1.12 | Decreased | Not established | q6h | q6h | q6h | Usual | Usual | Allergic reactions (rare: anaphylactic), diarrhea, nausea, vomiting |
| Doripenem | Doribax | 500 mg IV q8h | −b | 250 mg IV vial: $25.30 500 mg IV vial: $45.99 | n.a. | B | q8h | 250 mg q8h | 250 mg q12h | −b | −b | Anaphylaxis, hypersensitivity, GI disturbance |
| Doxycycline | Vibramycin | 0.1 g PO, IV q12h | 2.2 mg/kg PO, IV q12–24h | 100 mg tablet: $4.06 100 mg IV vial: $18.02 | Decreased with milk, antacids | D | q12h | q12h | q12h | Usual | Usual | GI disturbance, photosensitivity reactions, hepatic toxicity, esophageal ulcers |
| Enoxacin | 0.4 g PO, IV q12h | N.R. | Data not available | Decreased | C | q12h | 0.1–0.2 g q12h | 0.1–0.2 g q12h | –b | –b | Nausea, vomiting, dizziness, headache, tremors, confusion | |
| Ertapenem | Invanz | 1 g IM/IV qd | 30 mg/kg/d IM/IV BID | 1 g vial: $84.89 | n.a. | B | 1 g IM/IV qd | CrCl ≤30: 500 mg qd | CrCl ≤30: 500 mg qd | 30% of daily dose should be supplemented pHD | –b | Thrombocytopenia, increased LFTs, diarrhea, allergic reactions |
| Erythromycin base | 0.25–0.5 g PO q6h | 30–50 mg/kg/d; divide q6h | Data not available | Decreased | B | q6h | q6h | q6h | Usual | Usual | GI disturbance; rare: allergic reactions, hepatic dysfunction, hearing loss | |
| Erythromycin estolate | 0.25–0.5 g PO q6h | 3–50 mg/kg/d; divide q6h | Data not available | Decreased | B | Usual | Usual | Usual | No change | No change | Cholestatic hepatitis, hearing loss or tinnitus, GI disturbance, hypersensitivity reactions | |
| Erythromycin ethyl succinate | EES, EryPed | 0.4 g PO q8h | 30–50 mg/kg/d divide PO q8h | 400 mg tablet: $3.26 | Increased | B | Usual | Usual | Usual | Usual | Usual | GI disturbance; rare: allergic reactions, hepatic dysfunction |
| Erythromycin lactobionate | 0.5–1 g IV q6h | 15–20 mg/kg/d; divide IV q6h | Data not available | n.a. | B | Usual | Usual | Usual | Usual | Usual | GI disturbance; rare: allergic reactions, hepatic dysfunction, hearing loss | |
| Fidaxomicin | Dificid | 200 PO BID | −b | 200 mg tablet: $177.46 | None | B | Usual dose | Usual dose | Usual dose | None | None | Nausea, vomiting, hypersensitivity reaction |
| Gatifloxacin | 400 mg daily PO or IV | −b | None | Usual dose | 400 mg ×1 then 50% q24h | −b | −b | −b | Hyperglycemia, hypoglycemia, QT prolongation, tendon rupture | |||
| Gentamicinc | Garamycin | 3–5 mg/kg/d; divide IV q8h 4–8 mg/d IT | 3–7.5 mg/kg/d; divide IV q8h (newborn: 0–7 d, 2.5 mg/kg q12h; 1–4 wk, 7.5 mg/kg/d q8h) | 100 mg/100 mL IV bag: $0.04 | n.a. | C | q8–12h | q12–48h | >48 h | 1–1.7 mg/kg pHD | 1 mg/2 L dialysate removed | Renal toxicity, vestibular and auditory toxicity, CNS reactions, neuromuscular blockade (rare) |
| Grepafloxacin | 400 mg or 600 mg daily | −b | Data not available | No change | −b | −b | −b | −b | −b | Phototoxicity, QT prolongation, tendon rupture | ||
| Imipenem | Primaxin | 0.5–1 g IV q6h | 15–25 mg/kg IV q6h (n.a.) (neonate: 0–7 d, 25 mg/kg q12h; 1–4 wk, 25 mg/kg q8h) | 250 mg IV vial: $11.76 500 mg IV vial: $23.52 | n.a. | C | q6h | 0.5 g q8–12h | 0.25–0.5 g q12h | 0.25–0.5 pHD then q12h | –b | Fever, rash, nausea, vomiting, diarrhea, seizures (rare) |
| Kanamycinc | Kantrex | 15 mg/kg/d; divide IV q8–12h | 15 mg/kg/d; divide IV q8–12h (newborn: 0–7 d, 15–20 mg/kg/d q12h; 1–4 wk, 15 mg/kg/d q8–12h) | 1 g vial: $19.32 | n.a. | D | q8–12h | q12–48h | >48 h | 4–5 mg/kg pHD | 3.75 mg/kg/d | Cranial nerve VIII and renal damage |
| Levofloxacin | Levaquin | 0.25–0.75 g/d PO or IV | N.R. | 250 mg tablet: $16.81 500 mg tablet: $19.26 750 mg tablet: $36.07 250 mg IV bag: $0.15 500 mg IV bag: $0.12 | Unchanged | C | Usual | 0.25 g q24–48h | 0.25 g q48h | 0.25 g q48h | 0.25 g q48h | Diarrhea, nausea, headache |
| Lincomycin | Lincocin | 0.5 g PO q6–8h 0.6–1 g IV q8–12h | 30–60 mg/kg/d; divide PO q6–8h 10–20 mg/kg/d; divide IV q6h | PO: data not available 300 mg/mL (10 mL) vial: $9.48 | Decreased | Not established | Usual | Usual | Usual | –b | –b | Diarrhea, including pseudomembranous colitis, allergic reactions |
| Linezolid | Zyvox | 600 mg PO/IV q12h | >12 y: 600 mg PO q12 0–11: 30 mg/kg PO/IV q8h | 600 mg tablet: $140.37 600 mg IV bag: $144.40 | Unchanged | C | Usual | Usual | Usual | 200 mg | –b | Leukopenia, pancytopenia,lactic acidosis, peripheral neuropathy, optic neuropathy |
| Lomefloxacin | 0.4 g PO q24h | N.R. | Data not available | Decrease | C | q24h | 0.2 g q24h | 0.2 g q24h | 0.4 g load, then 0.2 g q24h | –b | Nausea, vomiting, dizziness, headache, tremors, confusion, photosensitivity | |
| Loracarbef | 0.2–0.4 g PO q12–24h | 15–30 mg/kg/d; q12h | Data not available | Decreased | B | q12–24h | q24–48h | q3–5d | Dose pHD | –b | Allergic reactions, GI disturbance | |
| Meropenem | Merrem | 0.5–1 g IV q8h | 20–40 mg/kg IV q8h | 500 mg IV vial: $9.24 1 g IV vial: $18.48 | n.a. | B | 0.5–1 g IV q8h | q12h | 0.25–0.5 q24h | –b | –b | Nausea, diarrhea, vomiting, rash |
| Metronidazole | Flagyl | 0.25–0.5 g PO q6–12h 0.5 g IV q6–8h | 15 mg/kg/d; divide TID (n.a.) | 250 mg tablet: $0.32 500 mg tablet: $0.59 500 mg IV bag: $2.50 | Unchanged | B | Usual | Usual | Usual | Usual | Usual | Nausea, headache, metallic taste |
| Mezlocillin | 3–4 g IV q4–6h | 50 mg/kg IV q4–6h | Data not available | n.a. | B | q4–6h | q8h | q8h | 2–3 g then 3–4 g q12h | 3 g q12h | Allergic reactions (rare: anaphylactic), diarrhea, nausea, vomiting | |
| Minocycline | Minocin, Dynacin | 0.1 g PO, IV q12h | 2 mg/kg PO, IV q12h | 100 mg capsule: $0.67 100 mg IV: $65.30 | Decreased with milk, antacids | D | q12h | q12h | q12h | Usual | Usual | GI disturbance, photosensitivity, hepatic toxicity, esophageal ulcers, vestibular toxicity; tooth discoloration |
| Moxifloxacin | Avelox | 400 mg PO/IV q24h | N.R. | 400 mg tablet: $27.52 400 mg IV: $46.08 | Absorption delayed | C | Usual | Usual | Usual | No change | No change | Anaphylaxis, phototoxicity,increased ICP, toxic psychosis |
| Nafcillin | Nallpen, Unipen | 0.5–2 g IV q4–6h | 150 mg/kg/d; divide IV q4–6h (neonate: 0–7 d, 25 mg/kg q8–12h; 1–4 wk, 25 mg/kg q6–8h) | 2 g IV bag: $24.95 | Decreased (PO) | B | q4–6h | q4–6h | q4–6h | Usual | Usual | Allergic reactions (rare: anaphylactic), diarrhea, nausea, vomiting; platelet dysfunction with high doses |
| Neomycin | Neo-tabs | 50 mg/kg/d; divide PO q6h | –‑ | 500 mg tablet: $1.36 | Neomycin not significantly absorbed PO | Not established | –b | –b | –b | –b | –b | Cranial nerve VIII and renal damage |
| Netilmicinc | 4–6.5 mg/kg/d; divide IV q8–12h | 3–7.5 mg/kg/d; divide IV q8–12h (newborn: 0–4 wk, 4–6.5 mg/kg/d q12h) | Data not available | n.a. | D | q8–12h | q12–48h | >48 h | 2 mg/kg pHD | –b | Renal toxicity, vestibular and auditory toxicity, CNS reactions, neuromuscular blockade (rare) | |
| Nitrofurantoin | Macrodantin, Macrobid | 0.05–0.1 g PO q6h | 5–7 mg/kg/d; divide q6h | 100 mg capsule (Macrobid): $17.11 100 mg capsule (Macrodantin): $3.91 | Increased | B | Usual | Avoid | Avoid | Avoid | Avoid | Rash, nausea/vomiting, pancreatitis, anemia, leukopenia, LFT elevation, neuropathy, urine discoloration |
| Norfloxacin | Noroxin | 0.4 g PO q12h | N.R. | 400 mg tablet: $4.84 | Decreased | C | q12h | q24h | q24h | –b | –b | Nausea, vomiting, dizziness, headache, tremors, confusion |
| Ofloxacin | Floxin | 0.2–0.4 g PO, IV q12h | N.R. | 200 mg tablet: $4.78 400 mg tablet: $6.00 IV: data not available | Decreased | C | q12h | q24h | 0.1–0.2 g q24h | 0.2 g load; then 0.1 g q24h | –b | Nausea, vomiting, dizziness, headache, tremors, confusion |
| Oxacillin | Bactocil | 0.5–1 g IV q4–6h | 37.5–50 mg/kg IV q6h (neonate: 0–7 d, 25 mg/kg q8–12h; 1–4 wk, 25 mg/kg q6–8h) | 1 g IV vial: $14.60 | Decreased | B | q4–6h | q4–6h | q4–6h | Usual | Usual | Allergic reactions (rare: anaphylactic), diarrhea, nausea, vomiting |
| Penicillin V | Pen–VeeK, Pen–V | 0.25–0.5 g PO q6h | 6.25–12.5 mg/kg PO q6h | 250 mg tablet: $0.46 500 mg tablet: $0.74 | Decreased | B | q6h | q6h | q6h | 250 mg | –b | Allergic reactions (rare: anaphylactic), diarrhea, nausea, vomiting |
| Penicillin G benzathine | Bicillin L-A | 600 000–2 400 000 U IM ×1 | 600 000 U IM ×1 (neonate: 1–4 wk, 50 000 U/kg IM ×1) | 600 000 units/mL (4 mL) IM injection: $37.51 | n.a. | B | Usual | Usual | Usual | Usual | Usual | Allergic reactions (rare: anaphylactic), diarrhea, nausea, vomiting |
| Penicillin G | 0.5–1 g PO q6h 1–4 million U IV q4–6h | 25 000–90 000 U/kg/d; divide q4–8h PO 25 000–400 000 U/kg/d; divide IV q4–6h (neonate: 0–7 d, 50 000–150 000 U/kg/d q8–12h; 1–4 wk, 75 000–200 000 U/kg/d q6–8h) | Data not available PO 2 million units/50 mL IV bag: $10.55 3 million units/50 mL IV bag: $10.95 | Decreased | B | q4–6h | q4–6h | 25%–50% of standard dose q4–6h | 500 000 U | –b | Allergic reactions (rare: anaphylactic), diarrhea, nausea, vomiting | |
| Piperacillin | 3–4 g IV q4–6h | 50 mg/kg IV q4–6h (n.a.) | Data not available | n.a. | B | q4–6h | q6–8h | q8–12h | 1 g pHD, then 2 g IV q8h | –b | Allergic reactions (rare: anaphylactic), diarrhea, nausea, vomiting; platelet dysfunction with high doses | |
| Piperacillin–tazobactam | Zosyn | 3.375 g IV q6–8h | 90–112.5 mg/kg IV q8h | 3.375 g IV vial: $21.46 | n.a. | B | q6–8h | 2.25 g q6h | 2.25 g q8h | –b | –b | Allergic reactions (rare: anaphylactic), diarrhea, nausea, vomiting |
| Polymyxin B | Aerosporin, Neosporin | 15 000–25 000 U/kg/d IV q12h | 15 000–25 000 U/kg/d IV q12h | 500 000 units vial: $12.00 | n.a. | Not established | q12h | q12h | 2250–3750 U/kg/d; divide q12h | –b | –b | Nephrotoxicity, flushing; CNS effects: confusion, seizures; allergic reactions |
| Procaine penicillin G | Wycillin | 0.6–1.2 million U IM q12h | 25 000–50 000 U/kg IM q12–24h | 600 000 units/mL (2 mL) IM injection: $16.92 | n.a. | B | q12h | q12h | q12h | –b | –b | Allergic reactions (rare: anaphylactic), diarrhea, nausea, vomiting |
| Quinupristin–dalfopristin | Synercid | 7.5 mg/kg IV q8h | –b | 350 mg IV vial: $247.46 | n.a. | –b | Usual | Usual | Usual | –b | –b | Pain at infusion site, thrombophlebitis, arthralgia, myalgia |
| Rifaximin | Xifaxan | 200 mg PO TID | –b | 200 mg tablet: $16.04 550 mg tablet: $26.43 | Unchanged | C | –b | –b | –b | –b | –b | Headache, constipation, vomiting |
| Sparfloxacin | 0.4 g PO ×1 d then 0.2 g/d | –b | No data available | Unchanged | C | Usual | 0.2 g q48h | 0.2 g q48h | –b | –b | Photosensitivity, diarrhea, nausea, headaches, cardiac arrhythmias in patients taking antiarrhythmic drugs | |
| Spectinomycin | 2 g IM qd | –b | Data not available | n.a. | B | q24h | q24h | q24h | –b | –b | Pain at injection site, nausea, allergic reactions | |
| Streptomycin | 0.5–1 g IV or IM q12h | 20–40 mg/kg/d; divide IV or IM q6–12h | 1 g IM injection: $22.50 | n.a. | D | q12h | 7.5 mg/kg q24h | 7.5 mg/kg q72–96h | 0.5 g pHD | –b | Cranial nerve VIII damage, paresthesias, rash, fever, renal toxicity, neuromuscular blockade, optic neuritis | |
| Sulfadiazine | Microsulfon | 2–4 g/d; PO q4–8h | 120–150 mg/kg/d; divide PO q4–6h | 500 mg tablet: $4.28 | Decreased | C | –b | –b | –b | –b | –b | Rash, photosensitivity, drug fever |
| Sulfamethoxazole | 1 g PO q8–12h | 50–60 mg/kg/d; divide PO q12h | Data not available | Decreased | C | –b | –b | –b | –b | –b | Rash, photosensitivity, drug fever | |
| Sulfisoxazole | 0.5–1 g PO q6h 25 mg/kg IV q6h | 120–150 mg/kg/d; divide PO q4–6h | Data not available | Decreased | C | q6h | q8–12h | q12–24h | –b | –b | Rash, photosensitivity, drug fever | |
| Teichoplanin | 0.2–0.4 g IV q24h | 10 mg/kg IV q24h | Data not available | n.a. | Not established | q24h | q48h | q72h | –b | –b | Ototoxicity | |
| Telavancin | Vibativ | 10 mg IV q24h | −b | 750 mg IV vial: $358.00 | n.a. | C | q24h | q48h | −b | −b | −b | Nephrotoxicity, nausea, QT prolongation |
| Telithromycin | Ketek | 800 mg PO qd | –b | 400 mg tablet: $17.27 | Unchanged | C | Usual | Usual | 600 mg PO qd | Dose pHD | –b | |
