Pasteurella multocida

Usually susceptible	Variable	Usually resistant
Penicillin and derivatives Ampicillin (± sulbactam) Amoxicillin (± clavulanate) Ticarcillin (± clavulanate) Piperacillin (± tazobactam)	Semisynthetic penicillins Oxacillin Dicloxacillin Cloxacillin Nafcillin	Vancomycin Clindamycin Erythromycin (oral)
Second- and third-generation cephalosporins ^a Cefuroxime Cefotetan Cefoxitin Cefixime ^b Cefprozil^b Loracarbef^b Cefpodoxime^b Ceftriaxone Ceftizoxime Cefotaxime Ceftazidime Advanced-generation cephalosporins Ceftaroline^b	Cefaclor First-generation cephalosporins Cephalexin Cefazolin Cephradine Cefadroxil Erythromycin (IV) Aminoglycosides Gentamicin Tobramycin Amikacin
Ciprofloxacin^b
Chloramphenicol
Trimethoprim–sulfamethoxazole^b
Aztreonam
Imipenem
Tetracycline
Doxycycline

a Cefaclor, an oral second-generation cephalosporin, is often not effective.

b There are few clinical data on the use of these agents but by in vitro testing they should be effective.

Table 146.2 Doses of the most efficacious agents for treatment of Pasteurella multocida

Agent	Oral	Parenteral
Penicillin V	500–750 mg q6h
Penicillin G		10 million to 20 million units/d divided q4h
Amoxicillin (± clavulanate)	250–500 mg q6h
Ampicillin	250–500 mg q6h	1–2 g q4–6h
Ampicillin–sulbactam		1.5–3 g q6h
Ticarcillin–clavulanate		3.1 g q4–8h
Piperacillin		3–4 g q4–6h
Cefuroxime	250–500 g q12h	750 mg–1.5 g q8h
Cefoxitin		1–2 g q4–8h
Cefotaxime		1–2 g q4–8h
Ceftriaxone		1–2 g q24h
Ciprofloxacin	500–750 mg q12h	400 mg q12h
TMP–SMX	160 mg TMP (1 DS tab) BID	10 mg/kg/d TMP divided q6–12h
Aztreonam		500 mg–2 g q6–12h
Imipenem		500 mg–1 g q6–8h
Meropenem		2 g q8h
Tetracycline	250–500 mg q6h	500 mg–1 g q12h
Doxycycline	100–200 mg q12h	100–200 mg q12h
Chloramphenicol	12.5–25 mg/kg q6h	12.5–25 mg/kg q6h

Abbreviations: TMP–SMX = trimethoprim–sulfamethoxazole; DS = double strength.

While Pasteurella is universally resistant to clindamycin and vancomycin, most strains are resistant to erythromycin, and only moderately sensitive to aminoglycosides.