Drug Detail:Doxycycline (eent) (monograph) (Medically reviewed)
Drug Class:
Usual Adult Dose for Acne
IV:
- Initial dose: 200 mg IV on the first day, given in 1 or 2 infusions
- Maintenance dose: 100 to 200 mg/day IV
ORAL:
Most Products:
- Initial dose: 200 mg orally on the first day, given in 2 divided doses (100 mg every 12 hours)
- Maintenance dose: 100 mg orally once a day OR 50 mg orally every 12 hours
- More severe infections (especially chronic urinary tract infections): 100 mg orally every 12 hours
Doryx(R) MPC:
- Initial dose: 240 mg orally on the first day, given in 2 divided doses (120 mg every 12 hours)
- Maintenance dose: 120 mg orally once a day or 60 mg orally every 12 hours
- More severe infections (especially chronic urinary tract infections): 120 mg orally every 12 hours
Comments:
- The IV maintenance dose depends on the severity of the infection; the 200 mg dose may be given in 1 or 2 infusions.
- If using a monohydrate formulation, the initial oral dose may be given in 2 or 4 divided doses (100 mg every 12 hours or 50 mg every 6 hours).
- With trachoma, infectious agent is not always eliminated (as assessed by immunofluorescence).
- When used in streptococcal infections, duration of therapy should be 10 days.
Uses:
- For the treatment of the following infections: Psittacosis (ornithosis) due to Chlamydophila psittaci; chancroid due to Haemophilus ducreyi; relapsing fever due to Borrelia recurrentis; Campylobacter fetus infections; bartonellosis due to Bartonella bacilliformis; trachoma or inclusion conjunctivitis due to Chlamydia trachomatis; respiratory tract infections due to Mycoplasma pneumoniae
- For the treatment of infections due to the following bacteria when bacteriological testing shows suitable susceptibility to this drug: Escherichia coli; Enterobacter aerogenes; Shigella species; Acinetobacter species; respiratory tract infections due to H influenzae or Klebsiella species; upper respiratory infections due to Streptococcus pneumoniae; urinary tract infections due to Klebsiella species
- When penicillin is contraindicated, as an alternative agent for the treatment of the following infections: Yaws due to Treponema pallidum subspecies pertenue; listeriosis due to Listeria monocytogenes; Vincent's infection due to Fusobacterium fusiforme; actinomycosis due to Actinomyces israelii; infections due to Clostridium species
- As adjunctive therapy for: Acute intestinal amebiasis; severe acne
Usual Adult Dose for Actinomycosis
IV:
- Initial dose: 200 mg IV on the first day, given in 1 or 2 infusions
- Maintenance dose: 100 to 200 mg/day IV
ORAL:
Most Products:
- Initial dose: 200 mg orally on the first day, given in 2 divided doses (100 mg every 12 hours)
- Maintenance dose: 100 mg orally once a day OR 50 mg orally every 12 hours
- More severe infections (especially chronic urinary tract infections): 100 mg orally every 12 hours
Doryx(R) MPC:
- Initial dose: 240 mg orally on the first day, given in 2 divided doses (120 mg every 12 hours)
- Maintenance dose: 120 mg orally once a day or 60 mg orally every 12 hours
- More severe infections (especially chronic urinary tract infections): 120 mg orally every 12 hours
Comments:
- The IV maintenance dose depends on the severity of the infection; the 200 mg dose may be given in 1 or 2 infusions.
- If using a monohydrate formulation, the initial oral dose may be given in 2 or 4 divided doses (100 mg every 12 hours or 50 mg every 6 hours).
- With trachoma, infectious agent is not always eliminated (as assessed by immunofluorescence).
- When used in streptococcal infections, duration of therapy should be 10 days.
Uses:
- For the treatment of the following infections: Psittacosis (ornithosis) due to Chlamydophila psittaci; chancroid due to Haemophilus ducreyi; relapsing fever due to Borrelia recurrentis; Campylobacter fetus infections; bartonellosis due to Bartonella bacilliformis; trachoma or inclusion conjunctivitis due to Chlamydia trachomatis; respiratory tract infections due to Mycoplasma pneumoniae
- For the treatment of infections due to the following bacteria when bacteriological testing shows suitable susceptibility to this drug: Escherichia coli; Enterobacter aerogenes; Shigella species; Acinetobacter species; respiratory tract infections due to H influenzae or Klebsiella species; upper respiratory infections due to Streptococcus pneumoniae; urinary tract infections due to Klebsiella species
- When penicillin is contraindicated, as an alternative agent for the treatment of the following infections: Yaws due to Treponema pallidum subspecies pertenue; listeriosis due to Listeria monocytogenes; Vincent's infection due to Fusobacterium fusiforme; actinomycosis due to Actinomyces israelii; infections due to Clostridium species
- As adjunctive therapy for: Acute intestinal amebiasis; severe acne
Usual Adult Dose for Amebiasis
IV:
- Initial dose: 200 mg IV on the first day, given in 1 or 2 infusions
- Maintenance dose: 100 to 200 mg/day IV
ORAL:
Most Products:
- Initial dose: 200 mg orally on the first day, given in 2 divided doses (100 mg every 12 hours)
- Maintenance dose: 100 mg orally once a day OR 50 mg orally every 12 hours
- More severe infections (especially chronic urinary tract infections): 100 mg orally every 12 hours
Doryx(R) MPC:
- Initial dose: 240 mg orally on the first day, given in 2 divided doses (120 mg every 12 hours)
- Maintenance dose: 120 mg orally once a day or 60 mg orally every 12 hours
- More severe infections (especially chronic urinary tract infections): 120 mg orally every 12 hours
Comments:
- The IV maintenance dose depends on the severity of the infection; the 200 mg dose may be given in 1 or 2 infusions.
- If using a monohydrate formulation, the initial oral dose may be given in 2 or 4 divided doses (100 mg every 12 hours or 50 mg every 6 hours).
- With trachoma, infectious agent is not always eliminated (as assessed by immunofluorescence).
- When used in streptococcal infections, duration of therapy should be 10 days.
Uses:
- For the treatment of the following infections: Psittacosis (ornithosis) due to Chlamydophila psittaci; chancroid due to Haemophilus ducreyi; relapsing fever due to Borrelia recurrentis; Campylobacter fetus infections; bartonellosis due to Bartonella bacilliformis; trachoma or inclusion conjunctivitis due to Chlamydia trachomatis; respiratory tract infections due to Mycoplasma pneumoniae
- For the treatment of infections due to the following bacteria when bacteriological testing shows suitable susceptibility to this drug: Escherichia coli; Enterobacter aerogenes; Shigella species; Acinetobacter species; respiratory tract infections due to H influenzae or Klebsiella species; upper respiratory infections due to Streptococcus pneumoniae; urinary tract infections due to Klebsiella species
- When penicillin is contraindicated, as an alternative agent for the treatment of the following infections: Yaws due to Treponema pallidum subspecies pertenue; listeriosis due to Listeria monocytogenes; Vincent's infection due to Fusobacterium fusiforme; actinomycosis due to Actinomyces israelii; infections due to Clostridium species
- As adjunctive therapy for: Acute intestinal amebiasis; severe acne
Usual Adult Dose for Chancroid
IV:
- Initial dose: 200 mg IV on the first day, given in 1 or 2 infusions
- Maintenance dose: 100 to 200 mg/day IV
ORAL:
Most Products:
- Initial dose: 200 mg orally on the first day, given in 2 divided doses (100 mg every 12 hours)
- Maintenance dose: 100 mg orally once a day OR 50 mg orally every 12 hours
- More severe infections (especially chronic urinary tract infections): 100 mg orally every 12 hours
Doryx(R) MPC:
- Initial dose: 240 mg orally on the first day, given in 2 divided doses (120 mg every 12 hours)
- Maintenance dose: 120 mg orally once a day or 60 mg orally every 12 hours
- More severe infections (especially chronic urinary tract infections): 120 mg orally every 12 hours
Comments:
- The IV maintenance dose depends on the severity of the infection; the 200 mg dose may be given in 1 or 2 infusions.
- If using a monohydrate formulation, the initial oral dose may be given in 2 or 4 divided doses (100 mg every 12 hours or 50 mg every 6 hours).
- With trachoma, infectious agent is not always eliminated (as assessed by immunofluorescence).
- When used in streptococcal infections, duration of therapy should be 10 days.
Uses:
- For the treatment of the following infections: Psittacosis (ornithosis) due to Chlamydophila psittaci; chancroid due to Haemophilus ducreyi; relapsing fever due to Borrelia recurrentis; Campylobacter fetus infections; bartonellosis due to Bartonella bacilliformis; trachoma or inclusion conjunctivitis due to Chlamydia trachomatis; respiratory tract infections due to Mycoplasma pneumoniae
- For the treatment of infections due to the following bacteria when bacteriological testing shows suitable susceptibility to this drug: Escherichia coli; Enterobacter aerogenes; Shigella species; Acinetobacter species; respiratory tract infections due to H influenzae or Klebsiella species; upper respiratory infections due to Streptococcus pneumoniae; urinary tract infections due to Klebsiella species
- When penicillin is contraindicated, as an alternative agent for the treatment of the following infections: Yaws due to Treponema pallidum subspecies pertenue; listeriosis due to Listeria monocytogenes; Vincent's infection due to Fusobacterium fusiforme; actinomycosis due to Actinomyces israelii; infections due to Clostridium species
- As adjunctive therapy for: Acute intestinal amebiasis; severe acne
Usual Adult Dose for Inclusion Conjunctivitis
IV:
- Initial dose: 200 mg IV on the first day, given in 1 or 2 infusions
- Maintenance dose: 100 to 200 mg/day IV
ORAL:
Most Products:
- Initial dose: 200 mg orally on the first day, given in 2 divided doses (100 mg every 12 hours)
- Maintenance dose: 100 mg orally once a day OR 50 mg orally every 12 hours
- More severe infections (especially chronic urinary tract infections): 100 mg orally every 12 hours
Doryx(R) MPC:
- Initial dose: 240 mg orally on the first day, given in 2 divided doses (120 mg every 12 hours)
- Maintenance dose: 120 mg orally once a day or 60 mg orally every 12 hours
- More severe infections (especially chronic urinary tract infections): 120 mg orally every 12 hours
Comments:
- The IV maintenance dose depends on the severity of the infection; the 200 mg dose may be given in 1 or 2 infusions.
- If using a monohydrate formulation, the initial oral dose may be given in 2 or 4 divided doses (100 mg every 12 hours or 50 mg every 6 hours).
- With trachoma, infectious agent is not always eliminated (as assessed by immunofluorescence).
- When used in streptococcal infections, duration of therapy should be 10 days.
Uses:
- For the treatment of the following infections: Psittacosis (ornithosis) due to Chlamydophila psittaci; chancroid due to Haemophilus ducreyi; relapsing fever due to Borrelia recurrentis; Campylobacter fetus infections; bartonellosis due to Bartonella bacilliformis; trachoma or inclusion conjunctivitis due to Chlamydia trachomatis; respiratory tract infections due to Mycoplasma pneumoniae
- For the treatment of infections due to the following bacteria when bacteriological testing shows suitable susceptibility to this drug: Escherichia coli; Enterobacter aerogenes; Shigella species; Acinetobacter species; respiratory tract infections due to H influenzae or Klebsiella species; upper respiratory infections due to Streptococcus pneumoniae; urinary tract infections due to Klebsiella species
- When penicillin is contraindicated, as an alternative agent for the treatment of the following infections: Yaws due to Treponema pallidum subspecies pertenue; listeriosis due to Listeria monocytogenes; Vincent's infection due to Fusobacterium fusiforme; actinomycosis due to Actinomyces israelii; infections due to Clostridium species
- As adjunctive therapy for: Acute intestinal amebiasis; severe acne
Usual Adult Dose for Mycoplasma Pneumonia
IV:
- Initial dose: 200 mg IV on the first day, given in 1 or 2 infusions
- Maintenance dose: 100 to 200 mg/day IV
ORAL:
Most Products:
- Initial dose: 200 mg orally on the first day, given in 2 divided doses (100 mg every 12 hours)
- Maintenance dose: 100 mg orally once a day OR 50 mg orally every 12 hours
- More severe infections (especially chronic urinary tract infections): 100 mg orally every 12 hours
Doryx(R) MPC:
- Initial dose: 240 mg orally on the first day, given in 2 divided doses (120 mg every 12 hours)
- Maintenance dose: 120 mg orally once a day or 60 mg orally every 12 hours
- More severe infections (especially chronic urinary tract infections): 120 mg orally every 12 hours
Comments:
- The IV maintenance dose depends on the severity of the infection; the 200 mg dose may be given in 1 or 2 infusions.
- If using a monohydrate formulation, the initial oral dose may be given in 2 or 4 divided doses (100 mg every 12 hours or 50 mg every 6 hours).
- With trachoma, infectious agent is not always eliminated (as assessed by immunofluorescence).
- When used in streptococcal infections, duration of therapy should be 10 days.
Uses:
- For the treatment of the following infections: Psittacosis (ornithosis) due to Chlamydophila psittaci; chancroid due to Haemophilus ducreyi; relapsing fever due to Borrelia recurrentis; Campylobacter fetus infections; bartonellosis due to Bartonella bacilliformis; trachoma or inclusion conjunctivitis due to Chlamydia trachomatis; respiratory tract infections due to Mycoplasma pneumoniae
- For the treatment of infections due to the following bacteria when bacteriological testing shows suitable susceptibility to this drug: Escherichia coli; Enterobacter aerogenes; Shigella species; Acinetobacter species; respiratory tract infections due to H influenzae or Klebsiella species; upper respiratory infections due to Streptococcus pneumoniae; urinary tract infections due to Klebsiella species
- When penicillin is contraindicated, as an alternative agent for the treatment of the following infections: Yaws due to Treponema pallidum subspecies pertenue; listeriosis due to Listeria monocytogenes; Vincent's infection due to Fusobacterium fusiforme; actinomycosis due to Actinomyces israelii; infections due to Clostridium species
- As adjunctive therapy for: Acute intestinal amebiasis; severe acne
Usual Adult Dose for Pneumonia
IV:
- Initial dose: 200 mg IV on the first day, given in 1 or 2 infusions
- Maintenance dose: 100 to 200 mg/day IV
ORAL:
Most Products:
- Initial dose: 200 mg orally on the first day, given in 2 divided doses (100 mg every 12 hours)
- Maintenance dose: 100 mg orally once a day OR 50 mg orally every 12 hours
- More severe infections (especially chronic urinary tract infections): 100 mg orally every 12 hours
Doryx(R) MPC:
- Initial dose: 240 mg orally on the first day, given in 2 divided doses (120 mg every 12 hours)
- Maintenance dose: 120 mg orally once a day or 60 mg orally every 12 hours
- More severe infections (especially chronic urinary tract infections): 120 mg orally every 12 hours
Comments:
- The IV maintenance dose depends on the severity of the infection; the 200 mg dose may be given in 1 or 2 infusions.
- If using a monohydrate formulation, the initial oral dose may be given in 2 or 4 divided doses (100 mg every 12 hours or 50 mg every 6 hours).
- With trachoma, infectious agent is not always eliminated (as assessed by immunofluorescence).
- When used in streptococcal infections, duration of therapy should be 10 days.
Uses:
- For the treatment of the following infections: Psittacosis (ornithosis) due to Chlamydophila psittaci; chancroid due to Haemophilus ducreyi; relapsing fever due to Borrelia recurrentis; Campylobacter fetus infections; bartonellosis due to Bartonella bacilliformis; trachoma or inclusion conjunctivitis due to Chlamydia trachomatis; respiratory tract infections due to Mycoplasma pneumoniae
- For the treatment of infections due to the following bacteria when bacteriological testing shows suitable susceptibility to this drug: Escherichia coli; Enterobacter aerogenes; Shigella species; Acinetobacter species; respiratory tract infections due to H influenzae or Klebsiella species; upper respiratory infections due to Streptococcus pneumoniae; urinary tract infections due to Klebsiella species
- When penicillin is contraindicated, as an alternative agent for the treatment of the following infections: Yaws due to Treponema pallidum subspecies pertenue; listeriosis due to Listeria monocytogenes; Vincent's infection due to Fusobacterium fusiforme; actinomycosis due to Actinomyces israelii; infections due to Clostridium species
- As adjunctive therapy for: Acute intestinal amebiasis; severe acne
Usual Adult Dose for Trachoma
IV:
- Initial dose: 200 mg IV on the first day, given in 1 or 2 infusions
- Maintenance dose: 100 to 200 mg/day IV
ORAL:
Most Products:
- Initial dose: 200 mg orally on the first day, given in 2 divided doses (100 mg every 12 hours)
- Maintenance dose: 100 mg orally once a day OR 50 mg orally every 12 hours
- More severe infections (especially chronic urinary tract infections): 100 mg orally every 12 hours
Doryx(R) MPC:
- Initial dose: 240 mg orally on the first day, given in 2 divided doses (120 mg every 12 hours)
- Maintenance dose: 120 mg orally once a day or 60 mg orally every 12 hours
- More severe infections (especially chronic urinary tract infections): 120 mg orally every 12 hours
Comments:
- The IV maintenance dose depends on the severity of the infection; the 200 mg dose may be given in 1 or 2 infusions.
- If using a monohydrate formulation, the initial oral dose may be given in 2 or 4 divided doses (100 mg every 12 hours or 50 mg every 6 hours).
- With trachoma, infectious agent is not always eliminated (as assessed by immunofluorescence).
- When used in streptococcal infections, duration of therapy should be 10 days.
Uses:
- For the treatment of the following infections: Psittacosis (ornithosis) due to Chlamydophila psittaci; chancroid due to Haemophilus ducreyi; relapsing fever due to Borrelia recurrentis; Campylobacter fetus infections; bartonellosis due to Bartonella bacilliformis; trachoma or inclusion conjunctivitis due to Chlamydia trachomatis; respiratory tract infections due to Mycoplasma pneumoniae
- For the treatment of infections due to the following bacteria when bacteriological testing shows suitable susceptibility to this drug: Escherichia coli; Enterobacter aerogenes; Shigella species; Acinetobacter species; respiratory tract infections due to H influenzae or Klebsiella species; upper respiratory infections due to Streptococcus pneumoniae; urinary tract infections due to Klebsiella species
- When penicillin is contraindicated, as an alternative agent for the treatment of the following infections: Yaws due to Treponema pallidum subspecies pertenue; listeriosis due to Listeria monocytogenes; Vincent's infection due to Fusobacterium fusiforme; actinomycosis due to Actinomyces israelii; infections due to Clostridium species
- As adjunctive therapy for: Acute intestinal amebiasis; severe acne
Usual Adult Dose for Upper Respiratory Tract Infection
IV:
- Initial dose: 200 mg IV on the first day, given in 1 or 2 infusions
- Maintenance dose: 100 to 200 mg/day IV
ORAL:
Most Products:
- Initial dose: 200 mg orally on the first day, given in 2 divided doses (100 mg every 12 hours)
- Maintenance dose: 100 mg orally once a day OR 50 mg orally every 12 hours
- More severe infections (especially chronic urinary tract infections): 100 mg orally every 12 hours
Doryx(R) MPC:
- Initial dose: 240 mg orally on the first day, given in 2 divided doses (120 mg every 12 hours)
- Maintenance dose: 120 mg orally once a day or 60 mg orally every 12 hours
- More severe infections (especially chronic urinary tract infections): 120 mg orally every 12 hours
Comments:
- The IV maintenance dose depends on the severity of the infection; the 200 mg dose may be given in 1 or 2 infusions.
- If using a monohydrate formulation, the initial oral dose may be given in 2 or 4 divided doses (100 mg every 12 hours or 50 mg every 6 hours).
- With trachoma, infectious agent is not always eliminated (as assessed by immunofluorescence).
- When used in streptococcal infections, duration of therapy should be 10 days.
Uses:
- For the treatment of the following infections: Psittacosis (ornithosis) due to Chlamydophila psittaci; chancroid due to Haemophilus ducreyi; relapsing fever due to Borrelia recurrentis; Campylobacter fetus infections; bartonellosis due to Bartonella bacilliformis; trachoma or inclusion conjunctivitis due to Chlamydia trachomatis; respiratory tract infections due to Mycoplasma pneumoniae
- For the treatment of infections due to the following bacteria when bacteriological testing shows suitable susceptibility to this drug: Escherichia coli; Enterobacter aerogenes; Shigella species; Acinetobacter species; respiratory tract infections due to H influenzae or Klebsiella species; upper respiratory infections due to Streptococcus pneumoniae; urinary tract infections due to Klebsiella species
- When penicillin is contraindicated, as an alternative agent for the treatment of the following infections: Yaws due to Treponema pallidum subspecies pertenue; listeriosis due to Listeria monocytogenes; Vincent's infection due to Fusobacterium fusiforme; actinomycosis due to Actinomyces israelii; infections due to Clostridium species
- As adjunctive therapy for: Acute intestinal amebiasis; severe acne
Usual Adult Dose for Bacterial Infection
IV:
- Initial dose: 200 mg IV on the first day, given in 1 or 2 infusions
- Maintenance dose: 100 to 200 mg/day IV
ORAL:
Most Products:
- Initial dose: 200 mg orally on the first day, given in 2 divided doses (100 mg every 12 hours)
- Maintenance dose: 100 mg orally once a day OR 50 mg orally every 12 hours
- More severe infections (especially chronic urinary tract infections): 100 mg orally every 12 hours
Doryx(R) MPC:
- Initial dose: 240 mg orally on the first day, given in 2 divided doses (120 mg every 12 hours)
- Maintenance dose: 120 mg orally once a day or 60 mg orally every 12 hours
- More severe infections (especially chronic urinary tract infections): 120 mg orally every 12 hours
Comments:
- The IV maintenance dose depends on the severity of the infection; the 200 mg dose may be given in 1 or 2 infusions.
- If using a monohydrate formulation, the initial oral dose may be given in 2 or 4 divided doses (100 mg every 12 hours or 50 mg every 6 hours).
- With trachoma, infectious agent is not always eliminated (as assessed by immunofluorescence).
- When used in streptococcal infections, duration of therapy should be 10 days.
Uses:
- For the treatment of the following infections: Psittacosis (ornithosis) due to Chlamydophila psittaci; chancroid due to Haemophilus ducreyi; relapsing fever due to Borrelia recurrentis; Campylobacter fetus infections; bartonellosis due to Bartonella bacilliformis; trachoma or inclusion conjunctivitis due to Chlamydia trachomatis; respiratory tract infections due to Mycoplasma pneumoniae
- For the treatment of infections due to the following bacteria when bacteriological testing shows suitable susceptibility to this drug: Escherichia coli; Enterobacter aerogenes; Shigella species; Acinetobacter species; respiratory tract infections due to H influenzae or Klebsiella species; upper respiratory infections due to Streptococcus pneumoniae; urinary tract infections due to Klebsiella species
- When penicillin is contraindicated, as an alternative agent for the treatment of the following infections: Yaws due to Treponema pallidum subspecies pertenue; listeriosis due to Listeria monocytogenes; Vincent's infection due to Fusobacterium fusiforme; actinomycosis due to Actinomyces israelii; infections due to Clostridium species
- As adjunctive therapy for: Acute intestinal amebiasis; severe acne
Usual Adult Dose for Urinary Tract Infection
IV:
- Initial dose: 200 mg IV on the first day, given in 1 or 2 infusions
- Maintenance dose: 100 to 200 mg/day IV
ORAL:
Most Products:
- Initial dose: 200 mg orally on the first day, given in 2 divided doses (100 mg every 12 hours)
- Maintenance dose: 100 mg orally once a day OR 50 mg orally every 12 hours
- More severe infections (especially chronic urinary tract infections): 100 mg orally every 12 hours
Doryx(R) MPC:
- Initial dose: 240 mg orally on the first day, given in 2 divided doses (120 mg every 12 hours)
- Maintenance dose: 120 mg orally once a day or 60 mg orally every 12 hours
- More severe infections (especially chronic urinary tract infections): 120 mg orally every 12 hours
Comments:
- The IV maintenance dose depends on the severity of the infection; the 200 mg dose may be given in 1 or 2 infusions.
- If using a monohydrate formulation, the initial oral dose may be given in 2 or 4 divided doses (100 mg every 12 hours or 50 mg every 6 hours).
- With trachoma, infectious agent is not always eliminated (as assessed by immunofluorescence).
- When used in streptococcal infections, duration of therapy should be 10 days.
Uses:
- For the treatment of the following infections: Psittacosis (ornithosis) due to Chlamydophila psittaci; chancroid due to Haemophilus ducreyi; relapsing fever due to Borrelia recurrentis; Campylobacter fetus infections; bartonellosis due to Bartonella bacilliformis; trachoma or inclusion conjunctivitis due to Chlamydia trachomatis; respiratory tract infections due to Mycoplasma pneumoniae
- For the treatment of infections due to the following bacteria when bacteriological testing shows suitable susceptibility to this drug: Escherichia coli; Enterobacter aerogenes; Shigella species; Acinetobacter species; respiratory tract infections due to H influenzae or Klebsiella species; upper respiratory infections due to Streptococcus pneumoniae; urinary tract infections due to Klebsiella species
- When penicillin is contraindicated, as an alternative agent for the treatment of the following infections: Yaws due to Treponema pallidum subspecies pertenue; listeriosis due to Listeria monocytogenes; Vincent's infection due to Fusobacterium fusiforme; actinomycosis due to Actinomyces israelii; infections due to Clostridium species
- As adjunctive therapy for: Acute intestinal amebiasis; severe acne
Usual Adult Dose for Bronchitis
IV:
- Initial dose: 200 mg IV on the first day, given in 1 or 2 infusions
- Maintenance dose: 100 to 200 mg/day IV
ORAL:
Most Products:
- Initial dose: 200 mg orally on the first day, given in 2 divided doses (100 mg every 12 hours)
- Maintenance dose: 100 mg orally once a day OR 50 mg orally every 12 hours
- More severe infections (especially chronic urinary tract infections): 100 mg orally every 12 hours
Doryx(R) MPC:
- Initial dose: 240 mg orally on the first day, given in 2 divided doses (120 mg every 12 hours)
- Maintenance dose: 120 mg orally once a day or 60 mg orally every 12 hours
- More severe infections (especially chronic urinary tract infections): 120 mg orally every 12 hours
Comments:
- The IV maintenance dose depends on the severity of the infection; the 200 mg dose may be given in 1 or 2 infusions.
- If using a monohydrate formulation, the initial oral dose may be given in 2 or 4 divided doses (100 mg every 12 hours or 50 mg every 6 hours).
- With trachoma, infectious agent is not always eliminated (as assessed by immunofluorescence).
- When used in streptococcal infections, duration of therapy should be 10 days.
Uses:
- For the treatment of the following infections: Psittacosis (ornithosis) due to Chlamydophila psittaci; chancroid due to Haemophilus ducreyi; relapsing fever due to Borrelia recurrentis; Campylobacter fetus infections; bartonellosis due to Bartonella bacilliformis; trachoma or inclusion conjunctivitis due to Chlamydia trachomatis; respiratory tract infections due to Mycoplasma pneumoniae
- For the treatment of infections due to the following bacteria when bacteriological testing shows suitable susceptibility to this drug: Escherichia coli; Enterobacter aerogenes; Shigella species; Acinetobacter species; respiratory tract infections due to H influenzae or Klebsiella species; upper respiratory infections due to Streptococcus pneumoniae; urinary tract infections due to Klebsiella species
- When penicillin is contraindicated, as an alternative agent for the treatment of the following infections: Yaws due to Treponema pallidum subspecies pertenue; listeriosis due to Listeria monocytogenes; Vincent's infection due to Fusobacterium fusiforme; actinomycosis due to Actinomyces israelii; infections due to Clostridium species
- As adjunctive therapy for: Acute intestinal amebiasis; severe acne
Usual Adult Dose for Psittacosis
IV:
- Initial dose: 200 mg IV on the first day, given in 1 or 2 infusions
- Maintenance dose: 100 to 200 mg/day IV
ORAL:
Most Products:
- Initial dose: 200 mg orally on the first day, given in 2 divided doses (100 mg every 12 hours)
- Maintenance dose: 100 mg orally once a day OR 50 mg orally every 12 hours
- More severe infections (especially chronic urinary tract infections): 100 mg orally every 12 hours
Doryx(R) MPC:
- Initial dose: 240 mg orally on the first day, given in 2 divided doses (120 mg every 12 hours)
- Maintenance dose: 120 mg orally once a day or 60 mg orally every 12 hours
- More severe infections (especially chronic urinary tract infections): 120 mg orally every 12 hours
Comments:
- The IV maintenance dose depends on the severity of the infection; the 200 mg dose may be given in 1 or 2 infusions.
- If using a monohydrate formulation, the initial oral dose may be given in 2 or 4 divided doses (100 mg every 12 hours or 50 mg every 6 hours).
- With trachoma, infectious agent is not always eliminated (as assessed by immunofluorescence).
- When used in streptococcal infections, duration of therapy should be 10 days.
Uses:
- For the treatment of the following infections: Psittacosis (ornithosis) due to Chlamydophila psittaci; chancroid due to Haemophilus ducreyi; relapsing fever due to Borrelia recurrentis; Campylobacter fetus infections; bartonellosis due to Bartonella bacilliformis; trachoma or inclusion conjunctivitis due to Chlamydia trachomatis; respiratory tract infections due to Mycoplasma pneumoniae
- For the treatment of infections due to the following bacteria when bacteriological testing shows suitable susceptibility to this drug: Escherichia coli; Enterobacter aerogenes; Shigella species; Acinetobacter species; respiratory tract infections due to H influenzae or Klebsiella species; upper respiratory infections due to Streptococcus pneumoniae; urinary tract infections due to Klebsiella species
- When penicillin is contraindicated, as an alternative agent for the treatment of the following infections: Yaws due to Treponema pallidum subspecies pertenue; listeriosis due to Listeria monocytogenes; Vincent's infection due to Fusobacterium fusiforme; actinomycosis due to Actinomyces israelii; infections due to Clostridium species
- As adjunctive therapy for: Acute intestinal amebiasis; severe acne
Usual Adult Dose for Ornithosis
IV:
- Initial dose: 200 mg IV on the first day, given in 1 or 2 infusions
- Maintenance dose: 100 to 200 mg/day IV
ORAL:
Most Products:
- Initial dose: 200 mg orally on the first day, given in 2 divided doses (100 mg every 12 hours)
- Maintenance dose: 100 mg orally once a day OR 50 mg orally every 12 hours
- More severe infections (especially chronic urinary tract infections): 100 mg orally every 12 hours
Doryx(R) MPC:
- Initial dose: 240 mg orally on the first day, given in 2 divided doses (120 mg every 12 hours)
- Maintenance dose: 120 mg orally once a day or 60 mg orally every 12 hours
- More severe infections (especially chronic urinary tract infections): 120 mg orally every 12 hours
Comments:
- The IV maintenance dose depends on the severity of the infection; the 200 mg dose may be given in 1 or 2 infusions.
- If using a monohydrate formulation, the initial oral dose may be given in 2 or 4 divided doses (100 mg every 12 hours or 50 mg every 6 hours).
- With trachoma, infectious agent is not always eliminated (as assessed by immunofluorescence).
- When used in streptococcal infections, duration of therapy should be 10 days.
Uses:
- For the treatment of the following infections: Psittacosis (ornithosis) due to Chlamydophila psittaci; chancroid due to Haemophilus ducreyi; relapsing fever due to Borrelia recurrentis; Campylobacter fetus infections; bartonellosis due to Bartonella bacilliformis; trachoma or inclusion conjunctivitis due to Chlamydia trachomatis; respiratory tract infections due to Mycoplasma pneumoniae
- For the treatment of infections due to the following bacteria when bacteriological testing shows suitable susceptibility to this drug: Escherichia coli; Enterobacter aerogenes; Shigella species; Acinetobacter species; respiratory tract infections due to H influenzae or Klebsiella species; upper respiratory infections due to Streptococcus pneumoniae; urinary tract infections due to Klebsiella species
- When penicillin is contraindicated, as an alternative agent for the treatment of the following infections: Yaws due to Treponema pallidum subspecies pertenue; listeriosis due to Listeria monocytogenes; Vincent's infection due to Fusobacterium fusiforme; actinomycosis due to Actinomyces israelii; infections due to Clostridium species
- As adjunctive therapy for: Acute intestinal amebiasis; severe acne
Usual Adult Dose for Bartonellosis
IV:
- Initial dose: 200 mg IV on the first day, given in 1 or 2 infusions
- Maintenance dose: 100 to 200 mg/day IV
ORAL:
Most Products:
- Initial dose: 200 mg orally on the first day, given in 2 divided doses (100 mg every 12 hours)
- Maintenance dose: 100 mg orally once a day OR 50 mg orally every 12 hours
- More severe infections (especially chronic urinary tract infections): 100 mg orally every 12 hours
Doryx(R) MPC:
- Initial dose: 240 mg orally on the first day, given in 2 divided doses (120 mg every 12 hours)
- Maintenance dose: 120 mg orally once a day or 60 mg orally every 12 hours
- More severe infections (especially chronic urinary tract infections): 120 mg orally every 12 hours
Comments:
- The IV maintenance dose depends on the severity of the infection; the 200 mg dose may be given in 1 or 2 infusions.
- If using a monohydrate formulation, the initial oral dose may be given in 2 or 4 divided doses (100 mg every 12 hours or 50 mg every 6 hours).
- With trachoma, infectious agent is not always eliminated (as assessed by immunofluorescence).
- When used in streptococcal infections, duration of therapy should be 10 days.
Uses:
- For the treatment of the following infections: Psittacosis (ornithosis) due to Chlamydophila psittaci; chancroid due to Haemophilus ducreyi; relapsing fever due to Borrelia recurrentis; Campylobacter fetus infections; bartonellosis due to Bartonella bacilliformis; trachoma or inclusion conjunctivitis due to Chlamydia trachomatis; respiratory tract infections due to Mycoplasma pneumoniae
- For the treatment of infections due to the following bacteria when bacteriological testing shows suitable susceptibility to this drug: Escherichia coli; Enterobacter aerogenes; Shigella species; Acinetobacter species; respiratory tract infections due to H influenzae or Klebsiella species; upper respiratory infections due to Streptococcus pneumoniae; urinary tract infections due to Klebsiella species
- When penicillin is contraindicated, as an alternative agent for the treatment of the following infections: Yaws due to Treponema pallidum subspecies pertenue; listeriosis due to Listeria monocytogenes; Vincent's infection due to Fusobacterium fusiforme; actinomycosis due to Actinomyces israelii; infections due to Clostridium species
- As adjunctive therapy for: Acute intestinal amebiasis; severe acne
Usual Adult Dose for Acne Rosacea
40 mg orally once a day in the morning
Comments:
- The 40 mg capsule formulation
- This product should be taken on an empty stomach, preferably at least 1 hour prior to or 2 hours after meals.
- No meaningful effect shown for generalized erythema of rosacea.
- Safety and efficacy have not been established beyond 9 months and 16 weeks, respectively.
- This product has not been evaluated for treatment of erythematous, telangiectatic, or ocular components of rosacea.
Use: For the treatment of only inflammatory lesions (papules and pustules) of rosacea
Usual Adult Dose for Inhalation Bacillus anthracis
Most products: 100 mg orally or IV twice a day
- Alternatively, Doryx(R) MPC: 120 mg orally twice a day
Comments:
- Parenteral therapy is recommended only when oral therapy is not indicated and should not be continued over an extended period.
- Oral therapy should be started as soon as possible.
- Treatment duration of 60 days includes any parenteral therapy plus oral therapy.
Use: For the treatment of anthrax due to Bacillus anthracis (including inhalational anthrax [postexposure]) to reduce the incidence or progression of disease after exposure to aerosolized B anthracis
US CDC Recommendations:
- IV: 200 mg IV initially then 100 mg IV every 12 hours
- Oral: 100 mg orally every 12 hours
Duration of Therapy:
Postexposure prophylaxis for B anthracis infection: 60 days
Systemic anthrax:
- When meningitis has been excluded: At least 2 weeks or until patient is clinically stable (whichever is longer)
- Patients exposed to aerosolized spores will require prophylaxis to complete an antimicrobial regimen of 60 days from onset of illness.
Cutaneous anthrax without systemic involvement:
- Bioterrorism-related cases: 60 days
- Naturally-acquired cases: 7 to 10 days
Comments:
- Recommended as a preferred oral drug for postexposure prophylaxis and for the treatment of cutaneous anthrax without systemic involvement
- Recommended as an alternative IV protein synthesis inhibitor for systemic anthrax when meningitis has been excluded
- Recommended for all strains (regardless of penicillin susceptibility or if susceptibility unknown) when used for postexposure prophylaxis or cutaneous anthrax without systemic involvement
- Systemic anthrax includes anthrax meningitis, inhalation anthrax, injection anthrax, gastrointestinal anthrax, and cutaneous anthrax with systemic involvement, extensive edema, or lesions of the head or neck.
- Current guidelines should be consulted for additional information.
Usual Adult Dose for Cutaneous Bacillus anthracis
Most products: 100 mg orally or IV twice a day
- Alternatively, Doryx(R) MPC: 120 mg orally twice a day
Comments:
- Parenteral therapy is recommended only when oral therapy is not indicated and should not be continued over an extended period.
- Oral therapy should be started as soon as possible.
- Treatment duration of 60 days includes any parenteral therapy plus oral therapy.
Use: For the treatment of anthrax due to Bacillus anthracis (including inhalational anthrax [postexposure]) to reduce the incidence or progression of disease after exposure to aerosolized B anthracis
US CDC Recommendations:
- IV: 200 mg IV initially then 100 mg IV every 12 hours
- Oral: 100 mg orally every 12 hours
Duration of Therapy:
Postexposure prophylaxis for B anthracis infection: 60 days
Systemic anthrax:
- When meningitis has been excluded: At least 2 weeks or until patient is clinically stable (whichever is longer)
- Patients exposed to aerosolized spores will require prophylaxis to complete an antimicrobial regimen of 60 days from onset of illness.
Cutaneous anthrax without systemic involvement:
- Bioterrorism-related cases: 60 days
- Naturally-acquired cases: 7 to 10 days
Comments:
- Recommended as a preferred oral drug for postexposure prophylaxis and for the treatment of cutaneous anthrax without systemic involvement
- Recommended as an alternative IV protein synthesis inhibitor for systemic anthrax when meningitis has been excluded
- Recommended for all strains (regardless of penicillin susceptibility or if susceptibility unknown) when used for postexposure prophylaxis or cutaneous anthrax without systemic involvement
- Systemic anthrax includes anthrax meningitis, inhalation anthrax, injection anthrax, gastrointestinal anthrax, and cutaneous anthrax with systemic involvement, extensive edema, or lesions of the head or neck.
- Current guidelines should be consulted for additional information.
Usual Adult Dose for Anthrax Prophylaxis
Most products: 100 mg orally or IV twice a day
- Alternatively, Doryx(R) MPC: 120 mg orally twice a day
Comments:
- Parenteral therapy is recommended only when oral therapy is not indicated and should not be continued over an extended period.
- Oral therapy should be started as soon as possible.
- Treatment duration of 60 days includes any parenteral therapy plus oral therapy.
Use: For the treatment of anthrax due to Bacillus anthracis (including inhalational anthrax [postexposure]) to reduce the incidence or progression of disease after exposure to aerosolized B anthracis
US CDC Recommendations:
- IV: 200 mg IV initially then 100 mg IV every 12 hours
- Oral: 100 mg orally every 12 hours
Duration of Therapy:
Postexposure prophylaxis for B anthracis infection: 60 days
Systemic anthrax:
- When meningitis has been excluded: At least 2 weeks or until patient is clinically stable (whichever is longer)
- Patients exposed to aerosolized spores will require prophylaxis to complete an antimicrobial regimen of 60 days from onset of illness.
Cutaneous anthrax without systemic involvement:
- Bioterrorism-related cases: 60 days
- Naturally-acquired cases: 7 to 10 days
Comments:
- Recommended as a preferred oral drug for postexposure prophylaxis and for the treatment of cutaneous anthrax without systemic involvement
- Recommended as an alternative IV protein synthesis inhibitor for systemic anthrax when meningitis has been excluded
- Recommended for all strains (regardless of penicillin susceptibility or if susceptibility unknown) when used for postexposure prophylaxis or cutaneous anthrax without systemic involvement
- Systemic anthrax includes anthrax meningitis, inhalation anthrax, injection anthrax, gastrointestinal anthrax, and cutaneous anthrax with systemic involvement, extensive edema, or lesions of the head or neck.
- Current guidelines should be consulted for additional information.
Usual Adult Dose for Brucellosis
IV:
- Initial dose: 200 mg IV on the first day, given in 1 or 2 infusions
- Maintenance dose: 100 to 200 mg/day IV
ORAL:
Most Products:
- Initial dose: 200 mg orally on the first day, given in 2 divided doses (100 mg every 12 hours)
- Maintenance dose: 100 mg orally once a day OR 50 mg orally every 12 hours
- More severe infections: 100 mg orally every 12 hours
Doryx(R) MPC:
- Initial dose: 240 mg orally on the first day, given in 2 divided doses (120 mg every 12 hours)
- Maintenance dose: 120 mg orally once a day or 60 mg orally every 12 hours
- More severe infections: 120 mg orally every 12 hours
Comments:
- The IV maintenance dose depends on the severity of the infection; the 200 mg dose may be given in 1 or 2 infusions.
- If using a monohydrate formulation, the initial oral dose may be given in 2 or 4 divided doses (100 mg every 12 hours or 50 mg every 6 hours).
- Coadministration with streptomycin is recommended.
- According to some experts, this drug should be used with rifampin for at least 6 to 8 weeks; current guidelines should be consulted for additional information.
Use: For the treatment of brucellosis due to Brucella species
Usual Adult Dose for Cholera
IV:
- Initial dose: 200 mg IV on the first day, given in 1 or 2 infusions
- Maintenance dose: 100 to 200 mg/day IV
ORAL:
Most Products:
- Initial dose: 200 mg orally on the first day, given in 2 divided doses (100 mg every 12 hours)
- Maintenance dose: 100 mg orally once a day OR 50 mg orally every 12 hours
- More severe infections: 100 mg orally every 12 hours
Doryx(R) MPC:
- Initial dose: 240 mg orally on the first day, given in 2 divided doses (120 mg every 12 hours)
- Maintenance dose: 120 mg orally once a day or 60 mg orally every 12 hours
- More severe infections: 120 mg orally every 12 hours
Comments:
- The IV maintenance dose depends on the severity of the infection; the 200 mg dose may be given in 1 or 2 infusions.
- If using a monohydrate formulation, the initial oral dose may be given in 2 or 4 divided doses (100 mg every 12 hours or 50 mg every 6 hours).
Use: For the treatment of cholera due to Vibrio cholerae
Infectious Diseases Society of America (IDSA) and Pan American Health Organization (PAHO) Recommendations: 300 mg orally once
Comments:
- Recommended for the treatment of infectious diarrhea due to V cholerae O1 or O139
- Current guidelines should be consulted for additional information.
Usual Adult Dose for Chlamydia Infection
Uncomplicated urethral, endocervical, or rectal infection:
- Most products: 100 mg orally twice a day
- Alternatively, Doryx(R) MPC: 120 mg orally twice a day
Alternative regimen for uncomplicated urethral or endocervical infection:
- Delayed-release tablets: 200 mg orally once a day
Duration of therapy: 7 days
Comments:
- These regimens (100 mg orally twice a day and 200 mg orally once a day) have been recommended by the US CDC for the treatment of chlamydial infections; current guidelines should be consulted for additional information.
- The patient's sexual partner(s) should also be evaluated/treated.
Uses: For the treatment of uncomplicated urethral, endocervical, or rectal infections due to C trachomatis
Usual Adult Dose for Epididymitis - Sexually Transmitted
Most products: 100 mg orally twice a day
- Alternatively, Doryx(R) MPC: 120 mg orally twice a day
Use: For the treatment of acute epididymo-orchitis due to C trachomatis or Neisseria gonorrhoeae
US CDC Recommendations: 100 mg orally twice a day for 10 days
Comments:
- With ceftriaxone, the recommended regimen for acute epididymitis most likely due to sexually transmitted chlamydia and gonorrhea
- The patient's sexual partner(s) should also be evaluated/treated.
- Current guidelines should be consulted for additional information.
Usual Adult Dose for Gonococcal Infection - Uncomplicated
Most products: 100 mg orally twice a day
- Alternatively, Doryx(R) MPC: 120 mg orally twice a day
Alternate single visit dose:
- Most products: 300 mg orally initially followed in 1 hour by a second 300 mg dose
- Alternatively, Doryx(R) MPC: 360 mg orally initially followed in 1 hour by a second 360 mg dose
Comments:
- Not recommended for anorectal infections in men.
Use: For the treatment of uncomplicated gonorrhea due to N gonorrhoeae
US CDC Recommendations: 100 mg orally twice a day for 7 days
Comments:
- With ceftriaxone (or cefixime), recommended for uncomplicated infections of the cervix, urethra, or rectum as an alternative second antimicrobial in patients with azithromycin allergy
- The patient's sexual partner(s) should also be evaluated/treated.
- Current guidelines should be consulted for additional information.
Usual Adult Dose for Granuloma Inguinale
IV:
- Initial dose: 200 mg IV on the first day, given in 1 or 2 infusions
- Maintenance dose: 100 to 200 mg/day IV
ORAL:
Most Products:
- Initial dose: 200 mg orally on the first day, given in 2 divided doses (100 mg every 12 hours)
- Maintenance dose: 100 mg orally once a day OR 50 mg orally every 12 hours
- More severe infections: 100 mg orally every 12 hours
Doryx(R) MPC:
- Initial dose: 240 mg orally on the first day, given in 2 divided doses (120 mg every 12 hours)
- Maintenance dose: 120 mg orally once a day or 60 mg orally every 12 hours
- More severe infections: 120 mg orally every 12 hours
Comments:
- The IV maintenance dose depends on the severity of the infection; the 200 mg dose may be given in 1 or 2 infusions.
- If using a monohydrate formulation, the initial oral dose may be given in 2 or 4 divided doses (100 mg every 12 hours or 50 mg every 6 hours).
Use: For the treatment of granuloma inguinale due to Klebsiella granulomatis
US CDC Recommendations: 100 mg orally twice a day
Duration of therapy: At least 3 weeks and until all lesions have completely healed
Comments:
- Recommended as an alternative regimen
- Another antibiotic (e.g., an aminoglycoside such as gentamicin) may be added if no improvement is observed after several days.
- The patient's sexual partner(s) should also be evaluated/treated.
- Current guidelines should be consulted for additional information.
Usual Adult Dose for Lymphogranuloma Venereum
IV:
- Initial dose: 200 mg IV on the first day, given in 1 or 2 infusions
- Maintenance dose: 100 to 200 mg/day IV
ORAL:
Most Products:
- Initial dose: 200 mg orally on the first day, given in 2 divided doses (100 mg every 12 hours)
- Maintenance dose: 100 mg orally once a day OR 50 mg orally every 12 hours
- More severe infections: 100 mg orally every 12 hours
Doryx(R) MPC:
- Initial dose: 240 mg orally on the first day, given in 2 divided doses (120 mg every 12 hours)
- Maintenance dose: 120 mg orally once a day or 60 mg orally every 12 hours
- More severe infections: 120 mg orally every 12 hours
Comments:
- The IV maintenance dose depends on the severity of the infection; the 200 mg dose may be given in 1 or 2 infusions.
- If using a monohydrate formulation, the initial oral dose may be given in 2 or 4 divided doses (100 mg every 12 hours or 50 mg every 6 hours).
Use: For the treatment of lymphogranuloma venereum due to C trachomatis
US CDC Recommendations: 100 mg orally twice a day for 21 days
Comments:
- Recommended as the preferred regimen
- Patients should be clinically monitored until signs/symptoms have resolved.
- Prolonged therapy may be needed for HIV-infected patients; delay in symptom resolution may occur.
- The patient's sexual partner(s) should also be evaluated/treated.
- Current guidelines should be consulted for additional information.
Usual Adult Dose for Nongonococcal Urethritis
Most products: 100 mg orally twice a day
- Alternatively, Doryx(R) MPC: 120 mg orally twice a day
Comments:
- According to the US CDC, this (100 mg orally twice a day) is a recommended regimen for chlamydial urethritis; current guidelines should be consulted for additional information.
- The patient's sexual partner(s) should also be evaluated/treated.
Use: For the treatment of nongonococcal urethritis due to C trachomatis or Ureaplasma urealyticum
Usual Adult Dose for Malaria Prophylaxis
Most products: 100 mg orally once a day
- Alternatively, Doryx(R) MPC: 120 mg orally once a day
Comments:
- Prophylaxis should start 1 to 2 days before travel to endemic area; should continue daily while in malarious areas and for 4 weeks after leaving such areas
- Prophylaxis with this drug should not exceed 4 months.
Use: For prophylaxis of malaria due to Plasmodium falciparum in short-term travelers (less than 4 months) to areas with chloroquine and/or pyrimethamine-sulfadoxine resistant strains
US CDC Recommendations: 100 mg orally once a day
Comments:
- Recommended for prophylaxis in all areas
- Not recommended for use during pregnancy.
- Current guidelines should be consulted for additional information.
Usual Adult Dose for Malaria
US CDC Recommendations:
- Uncomplicated malaria: 100 mg orally twice a day for 7 days
- Severe malaria: 100 mg orally or IV twice a day for 7 days
Comments:
- With quinine, recommended for uncomplicated malaria due to chloroquine-resistant P falciparum
- With quinine and primaquine, recommended for uncomplicated malaria due to chloroquine-resistant P vivax
- With quinine, recommended for severe malaria
- Current guidelines should be consulted for additional information.
Usual Adult Dose for Periodontitis
20 mg orally twice a day for up to 9 months
Comments:
- The 20 mg capsule or tablet formulation
- This product should be taken at least 1 hour prior to or 2 hours after meals.
- Safety and efficacy have not been established beyond 12 months and 9 months, respectively.
Use: As an adjunct to scaling and root planing to promote attachment level gain and to reduce pocket depth in patients with periodontitis
Usual Adult Dose for Plague
IV:
- Initial dose: 200 mg IV on the first day, given in 1 or 2 infusions
- Maintenance dose: 100 to 200 mg/day IV
ORAL:
Most Products:
- Initial dose: 200 mg orally on the first day, given in 2 divided doses (100 mg every 12 hours)
- Maintenance dose: 100 mg orally once a day OR 50 mg orally every 12 hours
- More severe infections: 100 mg orally every 12 hours
Doryx(R) MPC:
- Initial dose: 240 mg orally on the first day, given in 2 divided doses (120 mg every 12 hours)
- Maintenance dose: 120 mg orally once a day or 60 mg orally every 12 hours
- More severe infections: 120 mg orally every 12 hours
Comments:
- The IV maintenance dose depends on the severity of the infection; the 200 mg dose may be given in 1 or 2 infusions.
- If using a monohydrate formulation, the initial oral dose may be given in 2 or 4 divided doses (100 mg every 12 hours or 50 mg every 6 hours).
Use: For the treatment of plague due to Yersinia pestis
US CDC Recommendations: 100 mg orally or IV twice a day or 200 mg orally or IV once a day
Duration of therapy: 10 to 14 days (or until 2 days after fever subsides)
Comments:
- In general, recommended as an alternative regimen for the treatment of plague
- IV therapy should be started as soon as plague suspected; may switch to oral therapy once patient improves
- Current guidelines should be consulted for additional information.
Usual Adult Dose for Plague Prophylaxis
US CDC Recommendations: 100 mg orally twice a day for 7 days
Comments:
- Recommended as a preferred agent for postexposure prophylaxis in patients with known exposure to plague (e.g., close contact with pneumonic plague patient, direct contact with infected body fluids/tissues)
- Current guidelines should be consulted for additional information.
Usual Adult Dose for Rickettsial Infection
IV:
- Initial dose: 200 mg IV on the first day, given in 1 or 2 infusions
- Maintenance dose: 100 to 200 mg/day IV
ORAL:
Most Products:
- Initial dose: 200 mg orally on the first day, given in 2 divided doses (100 mg every 12 hours)
- Maintenance dose: 100 mg orally once a day OR 50 mg orally every 12 hours
- More severe infections: 100 mg orally every 12 hours
Doryx(R) MPC:
- Initial dose: 240 mg orally on the first day, given in 2 divided doses (120 mg every 12 hours)
- Maintenance dose: 120 mg orally once a day or 60 mg orally every 12 hours
- More severe infections: 120 mg orally every 12 hours
Comments:
- The IV maintenance dose depends on the severity of the infection; the 200 mg dose may be given in 1 or 2 infusions.
- If using a monohydrate formulation, the initial oral dose may be given in 2 or 4 divided doses (100 mg every 12 hours or 50 mg every 6 hours).
Uses: For the treatment of rickettsial infections including Rocky Mountain spotted fever (RMSF), typhus fever and the typhus group, Q fever, rickettsialpox, and tick fevers due to Rickettsia species
US CDC Recommendations: 100 mg orally or IV twice a day
Duration of Therapy:
- RMSF, ehrlichiosis: At least 3 days after fever subsides and until evidence of clinical improvement
- Anaplasmosis: 10 days
Comments:
- Recommended as drug of choice for all tickborne rickettsial diseases
- Tickborne rickettsial diseases include RMSF due to Rickettsia rickettsii, other spotted fever group rickettsioses due to R parkeri and Rickettsia species 364D, Ehrlichia chaffeensis ehrlichiosis (i.e., human monocytic ehrlichiosis), other ehrlichioses due to E ewingii and E muris-like agent, and anaplasmosis due to Anaplasma phagocytophilum (i.e., human granulocytic anaplasmosis).
- The usual minimum duration of therapy for RMSF and ehrlichiosis is 5 to 7 days (total); severe/complicated disease may require longer therapy.
- According to some experts, typical duration of therapy for ehrlichiosis is 7 to 14 days.
- Current guidelines should be consulted for additional information.
Usual Adult Dose for Q Fever
IV:
- Initial dose: 200 mg IV on the first day, given in 1 or 2 infusions
- Maintenance dose: 100 to 200 mg/day IV
ORAL:
Most Products:
- Initial dose: 200 mg orally on the first day, given in 2 divided doses (100 mg every 12 hours)
- Maintenance dose: 100 mg orally once a day OR 50 mg orally every 12 hours
- More severe infections: 100 mg orally every 12 hours
Doryx(R) MPC:
- Initial dose: 240 mg orally on the first day, given in 2 divided doses (120 mg every 12 hours)
- Maintenance dose: 120 mg orally once a day or 60 mg orally every 12 hours
- More severe infections: 120 mg orally every 12 hours
Comments:
- The IV maintenance dose depends on the severity of the infection; the 200 mg dose may be given in 1 or 2 infusions.
- If using a monohydrate formulation, the initial oral dose may be given in 2 or 4 divided doses (100 mg every 12 hours or 50 mg every 6 hours).
Uses: For the treatment of rickettsial infections including Rocky Mountain spotted fever (RMSF), typhus fever and the typhus group, Q fever, rickettsialpox, and tick fevers due to Rickettsia species
US CDC Recommendations: 100 mg orally or IV twice a day
Duration of Therapy:
- RMSF, ehrlichiosis: At least 3 days after fever subsides and until evidence of clinical improvement
- Anaplasmosis: 10 days
Comments:
- Recommended as drug of choice for all tickborne rickettsial diseases
- Tickborne rickettsial diseases include RMSF due to Rickettsia rickettsii, other spotted fever group rickettsioses due to R parkeri and Rickettsia species 364D, Ehrlichia chaffeensis ehrlichiosis (i.e., human monocytic ehrlichiosis), other ehrlichioses due to E ewingii and E muris-like agent, and anaplasmosis due to Anaplasma phagocytophilum (i.e., human granulocytic anaplasmosis).
- The usual minimum duration of therapy for RMSF and ehrlichiosis is 5 to 7 days (total); severe/complicated disease may require longer therapy.
- According to some experts, typical duration of therapy for ehrlichiosis is 7 to 14 days.
- Current guidelines should be consulted for additional information.
Usual Adult Dose for Skin or Soft Tissue Infection
Initial dose: 200 mg IV on the first day, given in 1 or 2 infusions
Maintenance dose: 100 to 200 mg/day IV
Comments:
- Not the drug of choice for any type of staphylococcal infection
- The maintenance dose depends on the severity of the infection; the 200 mg dose may be given in 1 or 2 infusions.
Use: For the treatment of skin and soft tissue infections due to Staphylococcus aureus when bacteriological testing shows suitable susceptibility to this drug
IDSA Recommendations: 100 mg orally or IV every 12 hours
Comments:
- Recommended as oral therapy for skin and soft tissue infections due to methicillin-susceptible and methicillin-resistant S aureus, bacillary angiomatosis, bubonic plague, tularemia, and infections after human bites
- Recommended as oral therapy for purulent cellulitis (cellulitis associated with purulent drainage/exudate without a drainable abscess) due to methicillin-resistant S aureus
- With other agents, recommended as a part of an IV regimen for necrotizing infections of the skin, fascia, and muscle due to Aeromonas hydrophila or V vulnificus
- Recommended oral or IV therapy for infections after animal bites
- Recommended duration of therapy for bacillary angiomatosis is 2 weeks to 2 months
- Current guidelines should be consulted for additional information.
Usual Adult Dose for Syphilis - Early
Early:
- Most products: 100 mg orally twice a day
- Alternatively, Doryx(R) MPC: 120 mg orally twice a day
More than 1-year duration:
- Most products: 100 mg orally twice a day
- Alternatively, Doryx(R) MPC: 120 mg orally twice a day
For the treatment of primary or secondary syphilis, some manufacturers recommend: 300 mg/day orally (in divided doses) or IV for at least 10 days
Comments:
- Penicillin is the drug of choice.
- The patient's sexual partner(s) should also be evaluated/treated.
Use: When penicillin is contraindicated, as alternative therapy for syphilis due to T pallidum
US CDC Recommendations:
- Primary or secondary syphilis: 100 mg orally twice a day for 14 days
- Latent syphilis: 100 mg orally twice a day for 28 days
Comments:
- Recommended for nonpregnant penicillin-allergic patients
- Penicillin-allergic pregnant patients or penicillin-allergic patients whose compliance cannot be ensured should be desensitized and treated with benzathine penicillin.
- Current guidelines should be consulted for additional information.
Usual Adult Dose for Syphilis - Latent
Early:
- Most products: 100 mg orally twice a day
- Alternatively, Doryx(R) MPC: 120 mg orally twice a day
More than 1-year duration:
- Most products: 100 mg orally twice a day
- Alternatively, Doryx(R) MPC: 120 mg orally twice a day
For the treatment of primary or secondary syphilis, some manufacturers recommend: 300 mg/day orally (in divided doses) or IV for at least 10 days
Comments:
- Penicillin is the drug of choice.
- The patient's sexual partner(s) should also be evaluated/treated.
Use: When penicillin is contraindicated, as alternative therapy for syphilis due to T pallidum
US CDC Recommendations:
- Primary or secondary syphilis: 100 mg orally twice a day for 14 days
- Latent syphilis: 100 mg orally twice a day for 28 days
Comments:
- Recommended for nonpregnant penicillin-allergic patients
- Penicillin-allergic pregnant patients or penicillin-allergic patients whose compliance cannot be ensured should be desensitized and treated with benzathine penicillin.
- Current guidelines should be consulted for additional information.
Usual Adult Dose for Tularemia
IV:
- Initial dose: 200 mg IV on the first day, given in 1 or 2 infusions
- Maintenance dose: 100 to 200 mg/day IV
ORAL:
Most Products:
- Initial dose: 200 mg orally on the first day, given in 2 divided doses (100 mg every 12 hours)
- Maintenance dose: 100 mg orally once a day OR 50 mg orally every 12 hours
- More severe infections: 100 mg orally every 12 hours
Doryx(R) MPC:
- Initial dose: 240 mg orally on the first day, given in 2 divided doses (120 mg every 12 hours)
- Maintenance dose: 120 mg orally once a day or 60 mg orally every 12 hours
- More severe infections: 120 mg orally every 12 hours
Comments:
- The IV maintenance dose depends on the severity of the infection; the 200 mg dose may be given in 1 or 2 infusions.
- If using a monohydrate formulation, the initial oral dose may be given in 2 or 4 divided doses (100 mg every 12 hours or 50 mg every 6 hours).
Use: For the treatment of tularemia due to Francisella tularensis
Working Group on Civilian Biodefense Recommendations: 100 mg orally or IV twice a day
Duration of Therapy:
- Postexposure prophylaxis: 14 days
- Treatment in a contained casualty setting: At least 14 days
- Treatment in a mass casualty setting: 14 to 21 days
Comments:
- Recommended as an alternative IV regimen for the treatment of tularemia in a contained casualty setting and for postexposure prophylaxis
- Recommended as a preferred oral regimen for the treatment of tularemia in a mass casualty setting and for postexposure prophylaxis
- If parenteral therapy is used initially, may switch to oral therapy when clinically indicated
- Current guidelines should be consulted for additional information.
Usual Adult Dose for Cervicitis
US CDC Recommendations: 100 mg orally twice a day for 7 days
Comments:
- Recommended regimen for presumptive therapy
- Concomitant treatment for gonococcal infection should be considered if patient is at risk for or lives in a community with a high incidence of gonorrhea.
- The patient's sexual partner(s) should also be evaluated/treated.
- Current guidelines should be consulted for additional information.
Usual Adult Dose for Joint Infection
IDSA Recommendations: 100 mg orally twice a day
Comments:
- Recommended for chronic oral antimicrobial suppression for prosthetic joint infection; as a preferred regimen against oxacillin-resistant staphylococci and as an alternative regimen against Propionibacterium species
Usual Adult Dose for Lyme Disease - Arthritis
IDSA Recommendations: 100 mg orally twice a day
Duration of Therapy:
- Acrodermatitis chronica atrophicans: 21 days
- Cardiac disease: 14 to 21 days
- Erythema migrans: 10 to 21 days
- Lyme arthritis: 28 days
Comments:
- Recommended for the treatment of early localized or early disseminated Lyme disease associated with erythema migrans when specific neurologic manifestations or advanced atrioventricular heart block absent, uncomplicated Lyme arthritis in patients without clinical evidence of neurologic disease, patients with atrioventricular heart block and/or myopericarditis associated with early Lyme disease, and acrodermatitis chronica atrophicans
- A parenteral antibiotic (e.g., ceftriaxone) is recommended as initial treatment of patients hospitalized for cardiac monitoring; an oral regimen may be used for completion of therapy and for ambulatory patients.
- Current guidelines should be consulted for additional information.
Usual Adult Dose for Lyme Disease - Carditis
IDSA Recommendations: 100 mg orally twice a day
Duration of Therapy:
- Acrodermatitis chronica atrophicans: 21 days
- Cardiac disease: 14 to 21 days
- Erythema migrans: 10 to 21 days
- Lyme arthritis: 28 days
Comments:
- Recommended for the treatment of early localized or early disseminated Lyme disease associated with erythema migrans when specific neurologic manifestations or advanced atrioventricular heart block absent, uncomplicated Lyme arthritis in patients without clinical evidence of neurologic disease, patients with atrioventricular heart block and/or myopericarditis associated with early Lyme disease, and acrodermatitis chronica atrophicans
- A parenteral antibiotic (e.g., ceftriaxone) is recommended as initial treatment of patients hospitalized for cardiac monitoring; an oral regimen may be used for completion of therapy and for ambulatory patients.
- Current guidelines should be consulted for additional information.
Usual Adult Dose for Lyme Disease - Erythema Chronicum Migrans
IDSA Recommendations: 100 mg orally twice a day
Duration of Therapy:
- Acrodermatitis chronica atrophicans: 21 days
- Cardiac disease: 14 to 21 days
- Erythema migrans: 10 to 21 days
- Lyme arthritis: 28 days
Comments:
- Recommended for the treatment of early localized or early disseminated Lyme disease associated with erythema migrans when specific neurologic manifestations or advanced atrioventricular heart block absent, uncomplicated Lyme arthritis in patients without clinical evidence of neurologic disease, patients with atrioventricular heart block and/or myopericarditis associated with early Lyme disease, and acrodermatitis chronica atrophicans
- A parenteral antibiotic (e.g., ceftriaxone) is recommended as initial treatment of patients hospitalized for cardiac monitoring; an oral regimen may be used for completion of therapy and for ambulatory patients.
- Current guidelines should be consulted for additional information.
Usual Adult Dose for Lyme Disease
IDSA Recommendations: 100 mg orally twice a day
Duration of Therapy:
- Acrodermatitis chronica atrophicans: 21 days
- Cardiac disease: 14 to 21 days
- Erythema migrans: 10 to 21 days
- Lyme arthritis: 28 days
Comments:
- Recommended for the treatment of early localized or early disseminated Lyme disease associated with erythema migrans when specific neurologic manifestations or advanced atrioventricular heart block absent, uncomplicated Lyme arthritis in patients without clinical evidence of neurologic disease, patients with atrioventricular heart block and/or myopericarditis associated with early Lyme disease, and acrodermatitis chronica atrophicans
- A parenteral antibiotic (e.g., ceftriaxone) is recommended as initial treatment of patients hospitalized for cardiac monitoring; an oral regimen may be used for completion of therapy and for ambulatory patients.
- Current guidelines should be consulted for additional information.
Usual Adult Dose for Lyme Disease - Neurologic
IDSA Recommendations: 100 to 200 mg orally twice a day
Duration of therapy: 14 days (range: 10 to 28 days)
Comments:
- Recommended as the preferred regimen for the treatment of nervous system Lyme disease (including the following syndromes: meningitis, any neurologic syndrome with CSF pleocytosis, peripheral nerve [radiculopathy, diffuse neuropathy, mononeuropathy multiplex, cranial neuropathy; normal CSF])
- Recommended in early Lyme disease for patients intolerant of beta-lactam antibiotics with acute neurologic disease manifested by meningitis or radiculopathy
- Current guidelines should be consulted for additional information.
Usual Adult Dose for Melioidosis
US CDC Recommendations: 100 mg orally every 12 hours
Duration of therapy: 3 to 6 months
Comments:
- This oral regimen may be started after 10 to 14 days of IV therapy.
- Current guidelines should be consulted for additional information.
Usual Adult Dose for Pelvic Inflammatory Disease
US CDC Recommendations: 100 mg orally or IV every 12 hours
Duration of therapy: 14 days
Comments:
- With other agents, recommended as part of a parenteral regimen or as part of an IM/oral regimen; also recommended as part of an alternative parenteral regimen
- This drug may be switched from IV to oral administration 24 to 48 hours after clinical improvement to complete 14 days of therapy.
- Current guidelines should be consulted for additional information.
Usual Adult Dose for Sinusitis
IDSA Recommendations: 100 mg orally twice a day or 200 mg orally once a day
Comments:
- Recommended as a second-line regimen for acute bacterial rhinosinusitis, as initial empirical therapy or for patients with beta-lactam allergy
- Current guidelines should be consulted for additional information.
Usual Adult Dose for Proctitis
US CDC Recommendations: 100 mg orally twice a day for 7 days
Comments:
- With ceftriaxone, the recommended regimen for sexually-acquired acute proctitis
- The patient's sexual partner(s) should also be evaluated/treated.
- Current guidelines should be consulted for additional information.
Usual Adult Dose for Wound Infection
US CDC Recommendations: 100 mg orally or IV twice a day for 7 to 14 days
Comments:
- In combination with a third-generation cephalosporin (e.g., ceftazidime), recommended for the treatment of V vulnificus wound infections
- Current guidelines should be consulted for additional information.
Usual Adult Dose for Pleural Effusion
Some Experts Recommend:
- Sclerosing agent: Mix 500 mg of the powder for injection and 10 mL of lidocaine 1% in 50 mL of normal saline and inject into pleural space.
Comments:
- Clinical trials have reported use of doses ranging from 250 mg to 1 g.
Usual Pediatric Dose for Acne
IV:
Less than 45 kg:
All patients with severe or life-threatening infections (e.g., RMSF): 2.2 mg/kg IV every 12 hours
Patients older than 8 years with less severe infections:
- Initial dose: 4.4 mg/kg IV on the first day, given in 2 infusions
- Maintenance dose: 2.2 mg/kg IV once a day or 1.1 mg/kg IV twice a day
At least 45 kg:
- Initial dose: 200 mg IV on the first day, given in 1 or 2 infusions
- Maintenance dose: 100 to 200 mg/day IV
ORAL:
Most Products:
Less than 45 kg:
All patients with severe or life-threatening infections: 2.2 mg/kg orally every 12 hours
Patients older than 8 years with less severe infections:
- Initial dose: 4.4 mg/kg orally on the first day, given in 2 divided doses
- Maintenance dose: 2.2 mg/kg orally once a day or 1.1 mg/kg orally twice a day
At least 45 kg:
- Initial dose: 200 mg orally on the first day, given in 2 divided doses (100 mg every 12 hours)
- Maintenance dose: 100 mg orally once a day OR 50 mg orally every 12 hours
- More severe infections: 100 mg orally every 12 hours
Doryx(R) MPC:
Less than 45 kg:
All patients with severe or life-threatening infections: 2.6 mg/kg orally every 12 hours
Patients older than 8 years with less severe infections:
- Initial dose: 5.3 mg/kg orally on the first day, given in 2 divided doses
- Maintenance dose: 2.6 mg/kg orally once a day or 1.3 mg/kg orally twice a day
At least 45 kg:
- Initial dose: 240 mg orally on the first day, given in 2 divided doses (120 mg every 12 hours)
- Maintenance dose: 120 mg orally once a day or 60 mg orally every 12 hours
- More severe infections: 120 mg orally every 12 hours
Comments:
- The IV maintenance dose for patients weighing at least 45 kg depends on the severity of the infection; the 200 mg dose may be given in 1 or 2 infusions.
- For patients at least 45 kg using a monohydrate formulation, the initial oral dose may be given in 2 or 4 divided doses (100 mg every 12 hours or 50 mg every 6 hours).
- With trachoma, the infectious agent is not always eliminated (as assessed by immunofluorescence).
- Coadministration with streptomycin recommended for brucellosis.
Uses:
- For the treatment of the following infection: Psittacosis (ornithosis) due to C psittaci; chancroid due to H ducreyi; relapsing fever due to B recurrentis; C fetus infections; brucellosis due to Brucella species; bartonellosis due to B bacilliformis; trachoma or inclusion conjunctivitis due to C trachomatis
- For the treatment of infections due to the following bacteria when bacteriological testing shows suitable susceptibility to this drug: E coli; E aerogenes; Shigella species; Acinetobacter species; urinary tract infections due to Klebsiella species
- When penicillin is contraindicated, as an alternative agent for the treatment of the following infections: Yaws due to T pallidum subspecies pertenue; listeriosis due to L monocytogenes; Vincent's infection due to F fusiforme; actinomycosis due to A israelii; infections due to Clostridium species
- As adjunctive therapy for: Acute intestinal amebiasis; severe acne
American Academy of Pediatrics (AAP) Recommendations:
1 month or older:
- Mild to moderate infections: 2 to 4 mg/kg/day orally or IV in 1 to 2 divided doses
- Severe infections: 2 mg/kg orally or IV every 12 hours
Comments:
- Risk of dental staining in children younger than 8 years is unlikely at the dose and duration recommended to treat serious infections.
- Current guidelines should be consulted for additional information.
Usual Pediatric Dose for Actinomycosis
IV:
Less than 45 kg:
All patients with severe or life-threatening infections (e.g., RMSF): 2.2 mg/kg IV every 12 hours
Patients older than 8 years with less severe infections:
- Initial dose: 4.4 mg/kg IV on the first day, given in 2 infusions
- Maintenance dose: 2.2 mg/kg IV once a day or 1.1 mg/kg IV twice a day
At least 45 kg:
- Initial dose: 200 mg IV on the first day, given in 1 or 2 infusions
- Maintenance dose: 100 to 200 mg/day IV
ORAL:
Most Products:
Less than 45 kg:
All patients with severe or life-threatening infections: 2.2 mg/kg orally every 12 hours
Patients older than 8 years with less severe infections:
- Initial dose: 4.4 mg/kg orally on the first day, given in 2 divided doses
- Maintenance dose: 2.2 mg/kg orally once a day or 1.1 mg/kg orally twice a day
At least 45 kg:
- Initial dose: 200 mg orally on the first day, given in 2 divided doses (100 mg every 12 hours)
- Maintenance dose: 100 mg orally once a day OR 50 mg orally every 12 hours
- More severe infections: 100 mg orally every 12 hours
Doryx(R) MPC:
Less than 45 kg:
All patients with severe or life-threatening infections: 2.6 mg/kg orally every 12 hours
Patients older than 8 years with less severe infections:
- Initial dose: 5.3 mg/kg orally on the first day, given in 2 divided doses
- Maintenance dose: 2.6 mg/kg orally once a day or 1.3 mg/kg orally twice a day
At least 45 kg:
- Initial dose: 240 mg orally on the first day, given in 2 divided doses (120 mg every 12 hours)
- Maintenance dose: 120 mg orally once a day or 60 mg orally every 12 hours
- More severe infections: 120 mg orally every 12 hours
Comments:
- The IV maintenance dose for patients weighing at least 45 kg depends on the severity of the infection; the 200 mg dose may be given in 1 or 2 infusions.
- For patients at least 45 kg using a monohydrate formulation, the initial oral dose may be given in 2 or 4 divided doses (100 mg every 12 hours or 50 mg every 6 hours).
- With trachoma, the infectious agent is not always eliminated (as assessed by immunofluorescence).
- Coadministration with streptomycin recommended for brucellosis.
Uses:
- For the treatment of the following infection: Psittacosis (ornithosis) due to C psittaci; chancroid due to H ducreyi; relapsing fever due to B recurrentis; C fetus infections; brucellosis due to Brucella species; bartonellosis due to B bacilliformis; trachoma or inclusion conjunctivitis due to C trachomatis
- For the treatment of infections due to the following bacteria when bacteriological testing shows suitable susceptibility to this drug: E coli; E aerogenes; Shigella species; Acinetobacter species; urinary tract infections due to Klebsiella species
- When penicillin is contraindicated, as an alternative agent for the treatment of the following infections: Yaws due to T pallidum subspecies pertenue; listeriosis due to L monocytogenes; Vincent's infection due to F fusiforme; actinomycosis due to A israelii; infections due to Clostridium species
- As adjunctive therapy for: Acute intestinal amebiasis; severe acne
American Academy of Pediatrics (AAP) Recommendations:
1 month or older:
- Mild to moderate infections: 2 to 4 mg/kg/day orally or IV in 1 to 2 divided doses
- Severe infections: 2 mg/kg orally or IV every 12 hours
Comments:
- Risk of dental staining in children younger than 8 years is unlikely at the dose and duration recommended to treat serious infections.
- Current guidelines should be consulted for additional information.
Usual Pediatric Dose for Amebiasis
IV:
Less than 45 kg:
All patients with severe or life-threatening infections (e.g., RMSF): 2.2 mg/kg IV every 12 hours
Patients older than 8 years with less severe infections:
- Initial dose: 4.4 mg/kg IV on the first day, given in 2 infusions
- Maintenance dose: 2.2 mg/kg IV once a day or 1.1 mg/kg IV twice a day
At least 45 kg:
- Initial dose: 200 mg IV on the first day, given in 1 or 2 infusions
- Maintenance dose: 100 to 200 mg/day IV
ORAL:
Most Products:
Less than 45 kg:
All patients with severe or life-threatening infections: 2.2 mg/kg orally every 12 hours
Patients older than 8 years with less severe infections:
- Initial dose: 4.4 mg/kg orally on the first day, given in 2 divided doses
- Maintenance dose: 2.2 mg/kg orally once a day or 1.1 mg/kg orally twice a day
At least 45 kg:
- Initial dose: 200 mg orally on the first day, given in 2 divided doses (100 mg every 12 hours)
- Maintenance dose: 100 mg orally once a day OR 50 mg orally every 12 hours
- More severe infections: 100 mg orally every 12 hours
Doryx(R) MPC:
Less than 45 kg:
All patients with severe or life-threatening infections: 2.6 mg/kg orally every 12 hours
Patients older than 8 years with less severe infections:
- Initial dose: 5.3 mg/kg orally on the first day, given in 2 divided doses
- Maintenance dose: 2.6 mg/kg orally once a day or 1.3 mg/kg orally twice a day
At least 45 kg:
- Initial dose: 240 mg orally on the first day, given in 2 divided doses (120 mg every 12 hours)
- Maintenance dose: 120 mg orally once a day or 60 mg orally every 12 hours
- More severe infections: 120 mg orally every 12 hours
Comments:
- The IV maintenance dose for patients weighing at least 45 kg depends on the severity of the infection; the 200 mg dose may be given in 1 or 2 infusions.
- For patients at least 45 kg using a monohydrate formulation, the initial oral dose may be given in 2 or 4 divided doses (100 mg every 12 hours or 50 mg every 6 hours).
- With trachoma, the infectious agent is not always eliminated (as assessed by immunofluorescence).
- Coadministration with streptomycin recommended for brucellosis.
Uses:
- For the treatment of the following infection: Psittacosis (ornithosis) due to C psittaci; chancroid due to H ducreyi; relapsing fever due to B recurrentis; C fetus infections; brucellosis due to Brucella species; bartonellosis due to B bacilliformis; trachoma or inclusion conjunctivitis due to C trachomatis
- For the treatment of infections due to the following bacteria when bacteriological testing shows suitable susceptibility to this drug: E coli; E aerogenes; Shigella species; Acinetobacter species; urinary tract infections due to Klebsiella species
- When penicillin is contraindicated, as an alternative agent for the treatment of the following infections: Yaws due to T pallidum subspecies pertenue; listeriosis due to L monocytogenes; Vincent's infection due to F fusiforme; actinomycosis due to A israelii; infections due to Clostridium species
- As adjunctive therapy for: Acute intestinal amebiasis; severe acne
American Academy of Pediatrics (AAP) Recommendations:
1 month or older:
- Mild to moderate infections: 2 to 4 mg/kg/day orally or IV in 1 to 2 divided doses
- Severe infections: 2 mg/kg orally or IV every 12 hours
Comments:
- Risk of dental staining in children younger than 8 years is unlikely at the dose and duration recommended to treat serious infections.
- Current guidelines should be consulted for additional information.
Usual Pediatric Dose for Brucellosis
IV:
Less than 45 kg:
All patients with severe or life-threatening infections (e.g., RMSF): 2.2 mg/kg IV every 12 hours
Patients older than 8 years with less severe infections:
- Initial dose: 4.4 mg/kg IV on the first day, given in 2 infusions
- Maintenance dose: 2.2 mg/kg IV once a day or 1.1 mg/kg IV twice a day
At least 45 kg:
- Initial dose: 200 mg IV on the first day, given in 1 or 2 infusions
- Maintenance dose: 100 to 200 mg/day IV
ORAL:
Most Products:
Less than 45 kg:
All patients with severe or life-threatening infections: 2.2 mg/kg orally every 12 hours
Patients older than 8 years with less severe infections:
- Initial dose: 4.4 mg/kg orally on the first day, given in 2 divided doses
- Maintenance dose: 2.2 mg/kg orally once a day or 1.1 mg/kg orally twice a day
At least 45 kg:
- Initial dose: 200 mg orally on the first day, given in 2 divided doses (100 mg every 12 hours)
- Maintenance dose: 100 mg orally once a day OR 50 mg orally every 12 hours
- More severe infections: 100 mg orally every 12 hours
Doryx(R) MPC:
Less than 45 kg:
All patients with severe or life-threatening infections: 2.6 mg/kg orally every 12 hours
Patients older than 8 years with less severe infections:
- Initial dose: 5.3 mg/kg orally on the first day, given in 2 divided doses
- Maintenance dose: 2.6 mg/kg orally once a day or 1.3 mg/kg orally twice a day
At least 45 kg:
- Initial dose: 240 mg orally on the first day, given in 2 divided doses (120 mg every 12 hours)
- Maintenance dose: 120 mg orally once a day or 60 mg orally every 12 hours
- More severe infections: 120 mg orally every 12 hours
Comments:
- The IV maintenance dose for patients weighing at least 45 kg depends on the severity of the infection; the 200 mg dose may be given in 1 or 2 infusions.
- For patients at least 45 kg using a monohydrate formulation, the initial oral dose may be given in 2 or 4 divided doses (100 mg every 12 hours or 50 mg every 6 hours).
- With trachoma, the infectious agent is not always eliminated (as assessed by immunofluorescence).
- Coadministration with streptomycin recommended for brucellosis.
Uses:
- For the treatment of the following infection: Psittacosis (ornithosis) due to C psittaci; chancroid due to H ducreyi; relapsing fever due to B recurrentis; C fetus infections; brucellosis due to Brucella species; bartonellosis due to B bacilliformis; trachoma or inclusion conjunctivitis due to C trachomatis
- For the treatment of infections due to the following bacteria when bacteriological testing shows suitable susceptibility to this drug: E coli; E aerogenes; Shigella species; Acinetobacter species; urinary tract infections due to Klebsiella species
- When penicillin is contraindicated, as an alternative agent for the treatment of the following infections: Yaws due to T pallidum subspecies pertenue; listeriosis due to L monocytogenes; Vincent's infection due to F fusiforme; actinomycosis due to A israelii; infections due to Clostridium species
- As adjunctive therapy for: Acute intestinal amebiasis; severe acne
American Academy of Pediatrics (AAP) Recommendations:
1 month or older:
- Mild to moderate infections: 2 to 4 mg/kg/day orally or IV in 1 to 2 divided doses
- Severe infections: 2 mg/kg orally or IV every 12 hours
Comments:
- Risk of dental staining in children younger than 8 years is unlikely at the dose and duration recommended to treat serious infections.
- Current guidelines should be consulted for additional information.
Usual Pediatric Dose for Chancroid
IV:
Less than 45 kg:
All patients with severe or life-threatening infections (e.g., RMSF): 2.2 mg/kg IV every 12 hours
Patients older than 8 years with less severe infections:
- Initial dose: 4.4 mg/kg IV on the first day, given in 2 infusions
- Maintenance dose: 2.2 mg/kg IV once a day or 1.1 mg/kg IV twice a day
At least 45 kg:
- Initial dose: 200 mg IV on the first day, given in 1 or 2 infusions
- Maintenance dose: 100 to 200 mg/day IV
ORAL:
Most Products:
Less than 45 kg:
All patients with severe or life-threatening infections: 2.2 mg/kg orally every 12 hours
Patients older than 8 years with less severe infections:
- Initial dose: 4.4 mg/kg orally on the first day, given in 2 divided doses
- Maintenance dose: 2.2 mg/kg orally once a day or 1.1 mg/kg orally twice a day
At least 45 kg:
- Initial dose: 200 mg orally on the first day, given in 2 divided doses (100 mg every 12 hours)
- Maintenance dose: 100 mg orally once a day OR 50 mg orally every 12 hours
- More severe infections: 100 mg orally every 12 hours
Doryx(R) MPC:
Less than 45 kg:
All patients with severe or life-threatening infections: 2.6 mg/kg orally every 12 hours
Patients older than 8 years with less severe infections:
- Initial dose: 5.3 mg/kg orally on the first day, given in 2 divided doses
- Maintenance dose: 2.6 mg/kg orally once a day or 1.3 mg/kg orally twice a day
At least 45 kg:
- Initial dose: 240 mg orally on the first day, given in 2 divided doses (120 mg every 12 hours)
- Maintenance dose: 120 mg orally once a day or 60 mg orally every 12 hours
- More severe infections: 120 mg orally every 12 hours
Comments:
- The IV maintenance dose for patients weighing at least 45 kg depends on the severity of the infection; the 200 mg dose may be given in 1 or 2 infusions.
- For patients at least 45 kg using a monohydrate formulation, the initial oral dose may be given in 2 or 4 divided doses (100 mg every 12 hours or 50 mg every 6 hours).
- With trachoma, the infectious agent is not always eliminated (as assessed by immunofluorescence).
- Coadministration with streptomycin recommended for brucellosis.
Uses:
- For the treatment of the following infection: Psittacosis (ornithosis) due to C psittaci; chancroid due to H ducreyi; relapsing fever due to B recurrentis; C fetus infections; brucellosis due to Brucella species; bartonellosis due to B bacilliformis; trachoma or inclusion conjunctivitis due to C trachomatis
- For the treatment of infections due to the following bacteria when bacteriological testing shows suitable susceptibility to this drug: E coli; E aerogenes; Shigella species; Acinetobacter species; urinary tract infections due to Klebsiella species
- When penicillin is contraindicated, as an alternative agent for the treatment of the following infections: Yaws due to T pallidum subspecies pertenue; listeriosis due to L monocytogenes; Vincent's infection due to F fusiforme; actinomycosis due to A israelii; infections due to Clostridium species
- As adjunctive therapy for: Acute intestinal amebiasis; severe acne
American Academy of Pediatrics (AAP) Recommendations:
1 month or older:
- Mild to moderate infections: 2 to 4 mg/kg/day orally or IV in 1 to 2 divided doses
- Severe infections: 2 mg/kg orally or IV every 12 hours
Comments:
- Risk of dental staining in children younger than 8 years is unlikely at the dose and duration recommended to treat serious infections.
- Current guidelines should be consulted for additional information.
Usual Pediatric Dose for Inclusion Conjunctivitis
IV:
Less than 45 kg:
All patients with severe or life-threatening infections (e.g., RMSF): 2.2 mg/kg IV every 12 hours
Patients older than 8 years with less severe infections:
- Initial dose: 4.4 mg/kg IV on the first day, given in 2 infusions
- Maintenance dose: 2.2 mg/kg IV once a day or 1.1 mg/kg IV twice a day
At least 45 kg:
- Initial dose: 200 mg IV on the first day, given in 1 or 2 infusions
- Maintenance dose: 100 to 200 mg/day IV
ORAL:
Most Products:
Less than 45 kg:
All patients with severe or life-threatening infections: 2.2 mg/kg orally every 12 hours
Patients older than 8 years with less severe infections:
- Initial dose: 4.4 mg/kg orally on the first day, given in 2 divided doses
- Maintenance dose: 2.2 mg/kg orally once a day or 1.1 mg/kg orally twice a day
At least 45 kg:
- Initial dose: 200 mg orally on the first day, given in 2 divided doses (100 mg every 12 hours)
- Maintenance dose: 100 mg orally once a day OR 50 mg orally every 12 hours
- More severe infections: 100 mg orally every 12 hours
Doryx(R) MPC:
Less than 45 kg:
All patients with severe or life-threatening infections: 2.6 mg/kg orally every 12 hours
Patients older than 8 years with less severe infections:
- Initial dose: 5.3 mg/kg orally on the first day, given in 2 divided doses
- Maintenance dose: 2.6 mg/kg orally once a day or 1.3 mg/kg orally twice a day
At least 45 kg:
- Initial dose: 240 mg orally on the first day, given in 2 divided doses (120 mg every 12 hours)
- Maintenance dose: 120 mg orally once a day or 60 mg orally every 12 hours
- More severe infections: 120 mg orally every 12 hours
Comments:
- The IV maintenance dose for patients weighing at least 45 kg depends on the severity of the infection; the 200 mg dose may be given in 1 or 2 infusions.
- For patients at least 45 kg using a monohydrate formulation, the initial oral dose may be given in 2 or 4 divided doses (100 mg every 12 hours or 50 mg every 6 hours).
- With trachoma, the infectious agent is not always eliminated (as assessed by immunofluorescence).
- Coadministration with streptomycin recommended for brucellosis.
Uses:
- For the treatment of the following infection: Psittacosis (ornithosis) due to C psittaci; chancroid due to H ducreyi; relapsing fever due to B recurrentis; C fetus infections; brucellosis due to Brucella species; bartonellosis due to B bacilliformis; trachoma or inclusion conjunctivitis due to C trachomatis
- For the treatment of infections due to the following bacteria when bacteriological testing shows suitable susceptibility to this drug: E coli; E aerogenes; Shigella species; Acinetobacter species; urinary tract infections due to Klebsiella species
- When penicillin is contraindicated, as an alternative agent for the treatment of the following infections: Yaws due to T pallidum subspecies pertenue; listeriosis due to L monocytogenes; Vincent's infection due to F fusiforme; actinomycosis due to A israelii; infections due to Clostridium species
- As adjunctive therapy for: Acute intestinal amebiasis; severe acne
American Academy of Pediatrics (AAP) Recommendations:
1 month or older:
- Mild to moderate infections: 2 to 4 mg/kg/day orally or IV in 1 to 2 divided doses
- Severe infections: 2 mg/kg orally or IV every 12 hours
Comments:
- Risk of dental staining in children younger than 8 years is unlikely at the dose and duration recommended to treat serious infections.
- Current guidelines should be consulted for additional information.
Usual Pediatric Dose for Trachoma
IV:
Less than 45 kg:
All patients with severe or life-threatening infections (e.g., RMSF): 2.2 mg/kg IV every 12 hours
Patients older than 8 years with less severe infections:
- Initial dose: 4.4 mg/kg IV on the first day, given in 2 infusions
- Maintenance dose: 2.2 mg/kg IV once a day or 1.1 mg/kg IV twice a day
At least 45 kg:
- Initial dose: 200 mg IV on the first day, given in 1 or 2 infusions
- Maintenance dose: 100 to 200 mg/day IV
ORAL:
Most Products:
Less than 45 kg:
All patients with severe or life-threatening infections: 2.2 mg/kg orally every 12 hours
Patients older than 8 years with less severe infections:
- Initial dose: 4.4 mg/kg orally on the first day, given in 2 divided doses
- Maintenance dose: 2.2 mg/kg orally once a day or 1.1 mg/kg orally twice a day
At least 45 kg:
- Initial dose: 200 mg orally on the first day, given in 2 divided doses (100 mg every 12 hours)
- Maintenance dose: 100 mg orally once a day OR 50 mg orally every 12 hours
- More severe infections: 100 mg orally every 12 hours
Doryx(R) MPC:
Less than 45 kg:
All patients with severe or life-threatening infections: 2.6 mg/kg orally every 12 hours
Patients older than 8 years with less severe infections:
- Initial dose: 5.3 mg/kg orally on the first day, given in 2 divided doses
- Maintenance dose: 2.6 mg/kg orally once a day or 1.3 mg/kg orally twice a day
At least 45 kg:
- Initial dose: 240 mg orally on the first day, given in 2 divided doses (120 mg every 12 hours)
- Maintenance dose: 120 mg orally once a day or 60 mg orally every 12 hours
- More severe infections: 120 mg orally every 12 hours
Comments:
- The IV maintenance dose for patients weighing at least 45 kg depends on the severity of the infection; the 200 mg dose may be given in 1 or 2 infusions.
- For patients at least 45 kg using a monohydrate formulation, the initial oral dose may be given in 2 or 4 divided doses (100 mg every 12 hours or 50 mg every 6 hours).
- With trachoma, the infectious agent is not always eliminated (as assessed by immunofluorescence).
- Coadministration with streptomycin recommended for brucellosis.
Uses:
- For the treatment of the following infection: Psittacosis (ornithosis) due to C psittaci; chancroid due to H ducreyi; relapsing fever due to B recurrentis; C fetus infections; brucellosis due to Brucella species; bartonellosis due to B bacilliformis; trachoma or inclusion conjunctivitis due to C trachomatis
- For the treatment of infections due to the following bacteria when bacteriological testing shows suitable susceptibility to this drug: E coli; E aerogenes; Shigella species; Acinetobacter species; urinary tract infections due to Klebsiella species
- When penicillin is contraindicated, as an alternative agent for the treatment of the following infections: Yaws due to T pallidum subspecies pertenue; listeriosis due to L monocytogenes; Vincent's infection due to F fusiforme; actinomycosis due to A israelii; infections due to Clostridium species
- As adjunctive therapy for: Acute intestinal amebiasis; severe acne
American Academy of Pediatrics (AAP) Recommendations:
1 month or older:
- Mild to moderate infections: 2 to 4 mg/kg/day orally or IV in 1 to 2 divided doses
- Severe infections: 2 mg/kg orally or IV every 12 hours
Comments:
- Risk of dental staining in children younger than 8 years is unlikely at the dose and duration recommended to treat serious infections.
- Current guidelines should be consulted for additional information.
Usual Pediatric Dose for Bacterial Infection
IV:
Less than 45 kg:
All patients with severe or life-threatening infections (e.g., RMSF): 2.2 mg/kg IV every 12 hours
Patients older than 8 years with less severe infections:
- Initial dose: 4.4 mg/kg IV on the first day, given in 2 infusions
- Maintenance dose: 2.2 mg/kg IV once a day or 1.1 mg/kg IV twice a day
At least 45 kg:
- Initial dose: 200 mg IV on the first day, given in 1 or 2 infusions
- Maintenance dose: 100 to 200 mg/day IV
ORAL:
Most Products:
Less than 45 kg:
All patients with severe or life-threatening infections: 2.2 mg/kg orally every 12 hours
Patients older than 8 years with less severe infections:
- Initial dose: 4.4 mg/kg orally on the first day, given in 2 divided doses
- Maintenance dose: 2.2 mg/kg orally once a day or 1.1 mg/kg orally twice a day
At least 45 kg:
- Initial dose: 200 mg orally on the first day, given in 2 divided doses (100 mg every 12 hours)
- Maintenance dose: 100 mg orally once a day OR 50 mg orally every 12 hours
- More severe infections: 100 mg orally every 12 hours
Doryx(R) MPC:
Less than 45 kg:
All patients with severe or life-threatening infections: 2.6 mg/kg orally every 12 hours
Patients older than 8 years with less severe infections:
- Initial dose: 5.3 mg/kg orally on the first day, given in 2 divided doses
- Maintenance dose: 2.6 mg/kg orally once a day or 1.3 mg/kg orally twice a day
At least 45 kg:
- Initial dose: 240 mg orally on the first day, given in 2 divided doses (120 mg every 12 hours)
- Maintenance dose: 120 mg orally once a day or 60 mg orally every 12 hours
- More severe infections: 120 mg orally every 12 hours
Comments:
- The IV maintenance dose for patients weighing at least 45 kg depends on the severity of the infection; the 200 mg dose may be given in 1 or 2 infusions.
- For patients at least 45 kg using a monohydrate formulation, the initial oral dose may be given in 2 or 4 divided doses (100 mg every 12 hours or 50 mg every 6 hours).
- With trachoma, the infectious agent is not always eliminated (as assessed by immunofluorescence).
- Coadministration with streptomycin recommended for brucellosis.
Uses:
- For the treatment of the following infection: Psittacosis (ornithosis) due to C psittaci; chancroid due to H ducreyi; relapsing fever due to B recurrentis; C fetus infections; brucellosis due to Brucella species; bartonellosis due to B bacilliformis; trachoma or inclusion conjunctivitis due to C trachomatis
- For the treatment of infections due to the following bacteria when bacteriological testing shows suitable susceptibility to this drug: E coli; E aerogenes; Shigella species; Acinetobacter species; urinary tract infections due to Klebsiella species
- When penicillin is contraindicated, as an alternative agent for the treatment of the following infections: Yaws due to T pallidum subspecies pertenue; listeriosis due to L monocytogenes; Vincent's infection due to F fusiforme; actinomycosis due to A israelii; infections due to Clostridium species
- As adjunctive therapy for: Acute intestinal amebiasis; severe acne
American Academy of Pediatrics (AAP) Recommendations:
1 month or older:
- Mild to moderate infections: 2 to 4 mg/kg/day orally or IV in 1 to 2 divided doses
- Severe infections: 2 mg/kg orally or IV every 12 hours
Comments:
- Risk of dental staining in children younger than 8 years is unlikely at the dose and duration recommended to treat serious infections.
- Current guidelines should be consulted for additional information.
Usual Pediatric Dose for Urinary Tract Infection
IV:
Less than 45 kg:
All patients with severe or life-threatening infections (e.g., RMSF): 2.2 mg/kg IV every 12 hours
Patients older than 8 years with less severe infections:
- Initial dose: 4.4 mg/kg IV on the first day, given in 2 infusions
- Maintenance dose: 2.2 mg/kg IV once a day or 1.1 mg/kg IV twice a day
At least 45 kg:
- Initial dose: 200 mg IV on the first day, given in 1 or 2 infusions
- Maintenance dose: 100 to 200 mg/day IV
ORAL:
Most Products:
Less than 45 kg:
All patients with severe or life-threatening infections: 2.2 mg/kg orally every 12 hours
Patients older than 8 years with less severe infections:
- Initial dose: 4.4 mg/kg orally on the first day, given in 2 divided doses
- Maintenance dose: 2.2 mg/kg orally once a day or 1.1 mg/kg orally twice a day
At least 45 kg:
- Initial dose: 200 mg orally on the first day, given in 2 divided doses (100 mg every 12 hours)
- Maintenance dose: 100 mg orally once a day OR 50 mg orally every 12 hours
- More severe infections: 100 mg orally every 12 hours
Doryx(R) MPC:
Less than 45 kg:
All patients with severe or life-threatening infections: 2.6 mg/kg orally every 12 hours
Patients older than 8 years with less severe infections:
- Initial dose: 5.3 mg/kg orally on the first day, given in 2 divided doses
- Maintenance dose: 2.6 mg/kg orally once a day or 1.3 mg/kg orally twice a day
At least 45 kg:
- Initial dose: 240 mg orally on the first day, given in 2 divided doses (120 mg every 12 hours)
- Maintenance dose: 120 mg orally once a day or 60 mg orally every 12 hours
- More severe infections: 120 mg orally every 12 hours
Comments:
- The IV maintenance dose for patients weighing at least 45 kg depends on the severity of the infection; the 200 mg dose may be given in 1 or 2 infusions.
- For patients at least 45 kg using a monohydrate formulation, the initial oral dose may be given in 2 or 4 divided doses (100 mg every 12 hours or 50 mg every 6 hours).
- With trachoma, the infectious agent is not always eliminated (as assessed by immunofluorescence).
- Coadministration with streptomycin recommended for brucellosis.
Uses:
- For the treatment of the following infection: Psittacosis (ornithosis) due to C psittaci; chancroid due to H ducreyi; relapsing fever due to B recurrentis; C fetus infections; brucellosis due to Brucella species; bartonellosis due to B bacilliformis; trachoma or inclusion conjunctivitis due to C trachomatis
- For the treatment of infections due to the following bacteria when bacteriological testing shows suitable susceptibility to this drug: E coli; E aerogenes; Shigella species; Acinetobacter species; urinary tract infections due to Klebsiella species
- When penicillin is contraindicated, as an alternative agent for the treatment of the following infections: Yaws due to T pallidum subspecies pertenue; listeriosis due to L monocytogenes; Vincent's infection due to F fusiforme; actinomycosis due to A israelii; infections due to Clostridium species
- As adjunctive therapy for: Acute intestinal amebiasis; severe acne
American Academy of Pediatrics (AAP) Recommendations:
1 month or older:
- Mild to moderate infections: 2 to 4 mg/kg/day orally or IV in 1 to 2 divided doses
- Severe infections: 2 mg/kg orally or IV every 12 hours
Comments:
- Risk of dental staining in children younger than 8 years is unlikely at the dose and duration recommended to treat serious infections.
- Current guidelines should be consulted for additional information.
Usual Pediatric Dose for Psittacosis
IV:
Less than 45 kg:
All patients with severe or life-threatening infections (e.g., RMSF): 2.2 mg/kg IV every 12 hours
Patients older than 8 years with less severe infections:
- Initial dose: 4.4 mg/kg IV on the first day, given in 2 infusions
- Maintenance dose: 2.2 mg/kg IV once a day or 1.1 mg/kg IV twice a day
At least 45 kg:
- Initial dose: 200 mg IV on the first day, given in 1 or 2 infusions
- Maintenance dose: 100 to 200 mg/day IV
ORAL:
Most Products:
Less than 45 kg:
All patients with severe or life-threatening infections: 2.2 mg/kg orally every 12 hours
Patients older than 8 years with less severe infections:
- Initial dose: 4.4 mg/kg orally on the first day, given in 2 divided doses
- Maintenance dose: 2.2 mg/kg orally once a day or 1.1 mg/kg orally twice a day
At least 45 kg:
- Initial dose: 200 mg orally on the first day, given in 2 divided doses (100 mg every 12 hours)
- Maintenance dose: 100 mg orally once a day OR 50 mg orally every 12 hours
- More severe infections: 100 mg orally every 12 hours
Doryx(R) MPC:
Less than 45 kg:
All patients with severe or life-threatening infections: 2.6 mg/kg orally every 12 hours
Patients older than 8 years with less severe infections:
- Initial dose: 5.3 mg/kg orally on the first day, given in 2 divided doses
- Maintenance dose: 2.6 mg/kg orally once a day or 1.3 mg/kg orally twice a day
At least 45 kg:
- Initial dose: 240 mg orally on the first day, given in 2 divided doses (120 mg every 12 hours)
- Maintenance dose: 120 mg orally once a day or 60 mg orally every 12 hours
- More severe infections: 120 mg orally every 12 hours
Comments:
- The IV maintenance dose for patients weighing at least 45 kg depends on the severity of the infection; the 200 mg dose may be given in 1 or 2 infusions.
- For patients at least 45 kg using a monohydrate formulation, the initial oral dose may be given in 2 or 4 divided doses (100 mg every 12 hours or 50 mg every 6 hours).
- With trachoma, the infectious agent is not always eliminated (as assessed by immunofluorescence).
- Coadministration with streptomycin recommended for brucellosis.
Uses:
- For the treatment of the following infection: Psittacosis (ornithosis) due to C psittaci; chancroid due to H ducreyi; relapsing fever due to B recurrentis; C fetus infections; brucellosis due to Brucella species; bartonellosis due to B bacilliformis; trachoma or inclusion conjunctivitis due to C trachomatis
- For the treatment of infections due to the following bacteria when bacteriological testing shows suitable susceptibility to this drug: E coli; E aerogenes; Shigella species; Acinetobacter species; urinary tract infections due to Klebsiella species
- When penicillin is contraindicated, as an alternative agent for the treatment of the following infections: Yaws due to T pallidum subspecies pertenue; listeriosis due to L monocytogenes; Vincent's infection due to F fusiforme; actinomycosis due to A israelii; infections due to Clostridium species
- As adjunctive therapy for: Acute intestinal amebiasis; severe acne
American Academy of Pediatrics (AAP) Recommendations:
1 month or older:
- Mild to moderate infections: 2 to 4 mg/kg/day orally or IV in 1 to 2 divided doses
- Severe infections: 2 mg/kg orally or IV every 12 hours
Comments:
- Risk of dental staining in children younger than 8 years is unlikely at the dose and duration recommended to treat serious infections.
- Current guidelines should be consulted for additional information.
Usual Pediatric Dose for Ornithosis
IV:
Less than 45 kg:
All patients with severe or life-threatening infections (e.g., RMSF): 2.2 mg/kg IV every 12 hours
Patients older than 8 years with less severe infections:
- Initial dose: 4.4 mg/kg IV on the first day, given in 2 infusions
- Maintenance dose: 2.2 mg/kg IV once a day or 1.1 mg/kg IV twice a day
At least 45 kg:
- Initial dose: 200 mg IV on the first day, given in 1 or 2 infusions
- Maintenance dose: 100 to 200 mg/day IV
ORAL:
Most Products:
Less than 45 kg:
All patients with severe or life-threatening infections: 2.2 mg/kg orally every 12 hours
Patients older than 8 years with less severe infections:
- Initial dose: 4.4 mg/kg orally on the first day, given in 2 divided doses
- Maintenance dose: 2.2 mg/kg orally once a day or 1.1 mg/kg orally twice a day
At least 45 kg:
- Initial dose: 200 mg orally on the first day, given in 2 divided doses (100 mg every 12 hours)
- Maintenance dose: 100 mg orally once a day OR 50 mg orally every 12 hours
- More severe infections: 100 mg orally every 12 hours
Doryx(R) MPC:
Less than 45 kg:
All patients with severe or life-threatening infections: 2.6 mg/kg orally every 12 hours
Patients older than 8 years with less severe infections:
- Initial dose: 5.3 mg/kg orally on the first day, given in 2 divided doses
- Maintenance dose: 2.6 mg/kg orally once a day or 1.3 mg/kg orally twice a day
At least 45 kg:
- Initial dose: 240 mg orally on the first day, given in 2 divided doses (120 mg every 12 hours)
- Maintenance dose: 120 mg orally once a day or 60 mg orally every 12 hours
- More severe infections: 120 mg orally every 12 hours
Comments:
- The IV maintenance dose for patients weighing at least 45 kg depends on the severity of the infection; the 200 mg dose may be given in 1 or 2 infusions.
- For patients at least 45 kg using a monohydrate formulation, the initial oral dose may be given in 2 or 4 divided doses (100 mg every 12 hours or 50 mg every 6 hours).
- With trachoma, the infectious agent is not always eliminated (as assessed by immunofluorescence).
- Coadministration with streptomycin recommended for brucellosis.
Uses:
- For the treatment of the following infection: Psittacosis (ornithosis) due to C psittaci; chancroid due to H ducreyi; relapsing fever due to B recurrentis; C fetus infections; brucellosis due to Brucella species; bartonellosis due to B bacilliformis; trachoma or inclusion conjunctivitis due to C trachomatis
- For the treatment of infections due to the following bacteria when bacteriological testing shows suitable susceptibility to this drug: E coli; E aerogenes; Shigella species; Acinetobacter species; urinary tract infections due to Klebsiella species
- When penicillin is contraindicated, as an alternative agent for the treatment of the following infections: Yaws due to T pallidum subspecies pertenue; listeriosis due to L monocytogenes; Vincent's infection due to F fusiforme; actinomycosis due to A israelii; infections due to Clostridium species
- As adjunctive therapy for: Acute intestinal amebiasis; severe acne
American Academy of Pediatrics (AAP) Recommendations:
1 month or older:
- Mild to moderate infections: 2 to 4 mg/kg/day orally or IV in 1 to 2 divided doses
- Severe infections: 2 mg/kg orally or IV every 12 hours
Comments:
- Risk of dental staining in children younger than 8 years is unlikely at the dose and duration recommended to treat serious infections.
- Current guidelines should be consulted for additional information.
Usual Pediatric Dose for Bartonellosis
IV:
Less than 45 kg:
All patients with severe or life-threatening infections (e.g., RMSF): 2.2 mg/kg IV every 12 hours
Patients older than 8 years with less severe infections:
- Initial dose: 4.4 mg/kg IV on the first day, given in 2 infusions
- Maintenance dose: 2.2 mg/kg IV once a day or 1.1 mg/kg IV twice a day
At least 45 kg:
- Initial dose: 200 mg IV on the first day, given in 1 or 2 infusions
- Maintenance dose: 100 to 200 mg/day IV
ORAL:
Most Products:
Less than 45 kg:
All patients with severe or life-threatening infections: 2.2 mg/kg orally every 12 hours
Patients older than 8 years with less severe infections:
- Initial dose: 4.4 mg/kg orally on the first day, given in 2 divided doses
- Maintenance dose: 2.2 mg/kg orally once a day or 1.1 mg/kg orally twice a day
At least 45 kg:
- Initial dose: 200 mg orally on the first day, given in 2 divided doses (100 mg every 12 hours)
- Maintenance dose: 100 mg orally once a day OR 50 mg orally every 12 hours
- More severe infections: 100 mg orally every 12 hours
Doryx(R) MPC:
Less than 45 kg:
All patients with severe or life-threatening infections: 2.6 mg/kg orally every 12 hours
Patients older than 8 years with less severe infections:
- Initial dose: 5.3 mg/kg orally on the first day, given in 2 divided doses
- Maintenance dose: 2.6 mg/kg orally once a day or 1.3 mg/kg orally twice a day
At least 45 kg:
- Initial dose: 240 mg orally on the first day, given in 2 divided doses (120 mg every 12 hours)
- Maintenance dose: 120 mg orally once a day or 60 mg orally every 12 hours
- More severe infections: 120 mg orally every 12 hours
Comments:
- The IV maintenance dose for patients weighing at least 45 kg depends on the severity of the infection; the 200 mg dose may be given in 1 or 2 infusions.
- For patients at least 45 kg using a monohydrate formulation, the initial oral dose may be given in 2 or 4 divided doses (100 mg every 12 hours or 50 mg every 6 hours).
- With trachoma, the infectious agent is not always eliminated (as assessed by immunofluorescence).
- Coadministration with streptomycin recommended for brucellosis.
Uses:
- For the treatment of the following infection: Psittacosis (ornithosis) due to C psittaci; chancroid due to H ducreyi; relapsing fever due to B recurrentis; C fetus infections; brucellosis due to Brucella species; bartonellosis due to B bacilliformis; trachoma or inclusion conjunctivitis due to C trachomatis
- For the treatment of infections due to the following bacteria when bacteriological testing shows suitable susceptibility to this drug: E coli; E aerogenes; Shigella species; Acinetobacter species; urinary tract infections due to Klebsiella species
- When penicillin is contraindicated, as an alternative agent for the treatment of the following infections: Yaws due to T pallidum subspecies pertenue; listeriosis due to L monocytogenes; Vincent's infection due to F fusiforme; actinomycosis due to A israelii; infections due to Clostridium species
- As adjunctive therapy for: Acute intestinal amebiasis; severe acne
American Academy of Pediatrics (AAP) Recommendations:
1 month or older:
- Mild to moderate infections: 2 to 4 mg/kg/day orally or IV in 1 to 2 divided doses
- Severe infections: 2 mg/kg orally or IV every 12 hours
Comments:
- Risk of dental staining in children younger than 8 years is unlikely at the dose and duration recommended to treat serious infections.
- Current guidelines should be consulted for additional information.
Usual Pediatric Dose for Inhalation Bacillus anthracis
Less than 45 kg:
- Most products: 2.2 mg/kg orally or IV twice a day
- Alternatively, Doryx(R) MPC: 2.6 mg/kg orally twice a day
At least 45 kg:
- Most products: 100 mg orally or IV twice a day
- Alternatively, Doryx(R) MPC: 120 mg orally twice a day
Duration of therapy: 60 days
Comments:
- Parenteral therapy is recommended only when oral therapy is not indicated and should not be continued over an extended period.
- Oral therapy should be started as soon as possible.
- Treatment duration of 60 days includes any parenteral therapy plus oral therapy.
Use: For the treatment of anthrax due to B anthracis (including inhalational anthrax [postexposure]) to reduce the incidence or progression of disease after exposure to aerosolized B anthracis
AAP Recommendations:
Term neonate (younger than 1 month): 4.4 mg/kg orally or IV initially then 2.2 mg/kg orally or IV every 12 hours
Children 1 month or older:
IV:
- Less than 45 kg: 4.4 mg/kg IV initially then 2.2 mg/kg IV every 12 hours
- At least 45 kg: 200 mg IV initially then 100 mg IV every 12 hours
ORAL:
- Less than 45 kg: 2.2 mg/kg orally every 12 hours
- At least 45 kg: 100 mg orally every 12 hours
Duration of Therapy:
Postexposure prophylaxis for B anthracis infection: 60 days after exposure
Systemic/severe anthrax when meningitis has been excluded:
- Term neonate (younger than 1 month): At least 2 to 3 weeks or until patient is clinically stable (whichever is longer)
- Children 1 month or older: At least 14 days or until patient is clinically stable (whichever is longer)
- Patients will require prophylaxis to complete an antimicrobial regimen of up to 60 days from onset of illness.
Cutaneous anthrax without systemic involvement:
- Bioterrorism-related cases: To complete an antimicrobial regimen of up to 60 days from onset of illness
- Naturally-acquired cases: 7 to 10 days
Follow-up for severe anthrax:
- Term neonate (younger than 1 month): To complete a regimen of at least 10 to 14 days
- Children 1 month or older: To complete a regimen of at least 14 days
- Patients may require prophylaxis to complete an antimicrobial regimen of up to 60 days from onset of illness.
Comments:
- Recommended for postexposure prophylaxis as a preferred oral drug in children 1 month or older and as an alternative oral drug for term neonates (younger than 1 month)
- Recommended as an alternative oral drug for the treatment of cutaneous anthrax without systemic involvement
- Recommended as an alternative protein synthesis inhibitor for the IV treatment of systemic/severe anthrax when meningitis has been excluded and for oral follow-up for severe anthrax
- Recommended for all strains (regardless of penicillin susceptibility or if susceptibility unknown) when used for postexposure prophylaxis or cutaneous anthrax without systemic involvement
- Systemic/severe anthrax includes anthrax meningitis, inhalation anthrax, injection anthrax, gastrointestinal anthrax, and cutaneous anthrax with systemic involvement, extensive edema, or lesions of the head or neck.
- Current guidelines should be consulted for additional information.
Usual Pediatric Dose for Cutaneous Bacillus anthracis
Less than 45 kg:
- Most products: 2.2 mg/kg orally or IV twice a day
- Alternatively, Doryx(R) MPC: 2.6 mg/kg orally twice a day
At least 45 kg:
- Most products: 100 mg orally or IV twice a day
- Alternatively, Doryx(R) MPC: 120 mg orally twice a day
Duration of therapy: 60 days
Comments:
- Parenteral therapy is recommended only when oral therapy is not indicated and should not be continued over an extended period.
- Oral therapy should be started as soon as possible.
- Treatment duration of 60 days includes any parenteral therapy plus oral therapy.
Use: For the treatment of anthrax due to B anthracis (including inhalational anthrax [postexposure]) to reduce the incidence or progression of disease after exposure to aerosolized B anthracis
AAP Recommendations:
Term neonate (younger than 1 month): 4.4 mg/kg orally or IV initially then 2.2 mg/kg orally or IV every 12 hours
Children 1 month or older:
IV:
- Less than 45 kg: 4.4 mg/kg IV initially then 2.2 mg/kg IV every 12 hours
- At least 45 kg: 200 mg IV initially then 100 mg IV every 12 hours
ORAL:
- Less than 45 kg: 2.2 mg/kg orally every 12 hours
- At least 45 kg: 100 mg orally every 12 hours
Duration of Therapy:
Postexposure prophylaxis for B anthracis infection: 60 days after exposure
Systemic/severe anthrax when meningitis has been excluded:
- Term neonate (younger than 1 month): At least 2 to 3 weeks or until patient is clinically stable (whichever is longer)
- Children 1 month or older: At least 14 days or until patient is clinically stable (whichever is longer)
- Patients will require prophylaxis to complete an antimicrobial regimen of up to 60 days from onset of illness.
Cutaneous anthrax without systemic involvement:
- Bioterrorism-related cases: To complete an antimicrobial regimen of up to 60 days from onset of illness
- Naturally-acquired cases: 7 to 10 days
Follow-up for severe anthrax:
- Term neonate (younger than 1 month): To complete a regimen of at least 10 to 14 days
- Children 1 month or older: To complete a regimen of at least 14 days
- Patients may require prophylaxis to complete an antimicrobial regimen of up to 60 days from onset of illness.
Comments:
- Recommended for postexposure prophylaxis as a preferred oral drug in children 1 month or older and as an alternative oral drug for term neonates (younger than 1 month)
- Recommended as an alternative oral drug for the treatment of cutaneous anthrax without systemic involvement
- Recommended as an alternative protein synthesis inhibitor for the IV treatment of systemic/severe anthrax when meningitis has been excluded and for oral follow-up for severe anthrax
- Recommended for all strains (regardless of penicillin susceptibility or if susceptibility unknown) when used for postexposure prophylaxis or cutaneous anthrax without systemic involvement
- Systemic/severe anthrax includes anthrax meningitis, inhalation anthrax, injection anthrax, gastrointestinal anthrax, and cutaneous anthrax with systemic involvement, extensive edema, or lesions of the head or neck.
- Current guidelines should be consulted for additional information.
Usual Pediatric Dose for Anthrax Prophylaxis
Less than 45 kg:
- Most products: 2.2 mg/kg orally or IV twice a day
- Alternatively, Doryx(R) MPC: 2.6 mg/kg orally twice a day
At least 45 kg:
- Most products: 100 mg orally or IV twice a day
- Alternatively, Doryx(R) MPC: 120 mg orally twice a day
Duration of therapy: 60 days
Comments:
- Parenteral therapy is recommended only when oral therapy is not indicated and should not be continued over an extended period.
- Oral therapy should be started as soon as possible.
- Treatment duration of 60 days includes any parenteral therapy plus oral therapy.
Use: For the treatment of anthrax due to B anthracis (including inhalational anthrax [postexposure]) to reduce the incidence or progression of disease after exposure to aerosolized B anthracis
AAP Recommendations:
Term neonate (younger than 1 month): 4.4 mg/kg orally or IV initially then 2.2 mg/kg orally or IV every 12 hours
Children 1 month or older:
IV:
- Less than 45 kg: 4.4 mg/kg IV initially then 2.2 mg/kg IV every 12 hours
- At least 45 kg: 200 mg IV initially then 100 mg IV every 12 hours
ORAL:
- Less than 45 kg: 2.2 mg/kg orally every 12 hours
- At least 45 kg: 100 mg orally every 12 hours
Duration of Therapy:
Postexposure prophylaxis for B anthracis infection: 60 days after exposure
Systemic/severe anthrax when meningitis has been excluded:
- Term neonate (younger than 1 month): At least 2 to 3 weeks or until patient is clinically stable (whichever is longer)
- Children 1 month or older: At least 14 days or until patient is clinically stable (whichever is longer)
- Patients will require prophylaxis to complete an antimicrobial regimen of up to 60 days from onset of illness.
Cutaneous anthrax without systemic involvement:
- Bioterrorism-related cases: To complete an antimicrobial regimen of up to 60 days from onset of illness
- Naturally-acquired cases: 7 to 10 days
Follow-up for severe anthrax:
- Term neonate (younger than 1 month): To complete a regimen of at least 10 to 14 days
- Children 1 month or older: To complete a regimen of at least 14 days
- Patients may require prophylaxis to complete an antimicrobial regimen of up to 60 days from onset of illness.
Comments:
- Recommended for postexposure prophylaxis as a preferred oral drug in children 1 month or older and as an alternative oral drug for term neonates (younger than 1 month)
- Recommended as an alternative oral drug for the treatment of cutaneous anthrax without systemic involvement
- Recommended as an alternative protein synthesis inhibitor for the IV treatment of systemic/severe anthrax when meningitis has been excluded and for oral follow-up for severe anthrax
- Recommended for all strains (regardless of penicillin susceptibility or if susceptibility unknown) when used for postexposure prophylaxis or cutaneous anthrax without systemic involvement
- Systemic/severe anthrax includes anthrax meningitis, inhalation anthrax, injection anthrax, gastrointestinal anthrax, and cutaneous anthrax with systemic involvement, extensive edema, or lesions of the head or neck.
- Current guidelines should be consulted for additional information.
Usual Pediatric Dose for Mycoplasma Pneumonia
IV:
Less than 45 kg:
All patients with severe or life-threatening infections: 2.2 mg/kg IV every 12 hours
Patients older than 8 years with less severe infections:
- Initial dose: 4.4 mg/kg IV on the first day, given in 2 infusions
- Maintenance dose: 2.2 mg/kg IV once a day or 1.1 mg/kg IV twice a day
At least 45 kg:
- Initial dose: 200 mg IV on the first day, given in 1 or 2 infusions
- Maintenance dose: 100 to 200 mg/day IV
ORAL:
Most Products:
Less than 45 kg:
All patients with severe or life-threatening infections: 2.2 mg/kg orally every 12 hours
Patients older than 8 years with less severe infections:
- Initial dose: 4.4 mg/kg orally on the first day, given in 2 divided doses
- Maintenance dose: 2.2 mg/kg orally once a day or 1.1 mg/kg orally twice a day
At least 45 kg:
- Initial dose: 200 mg orally on the first day, given in 2 divided doses (100 mg every 12 hours)
- Maintenance dose: 100 mg orally once a day OR 50 mg orally every 12 hours
- More severe infections: 100 mg orally every 12 hours
Doryx(R) MPC:
Less than 45 kg:
All patients with severe or life-threatening infections: 2.6 mg/kg orally every 12 hours
Patients older than 8 years with less severe infections:
- Initial dose: 5.3 mg/kg orally on the first day, given in 2 divided doses
- Maintenance dose: 2.6 mg/kg orally once a day or 1.3 mg/kg orally twice a day
At least 45 kg:
- Initial dose: 240 mg orally on the first day, given in 2 divided doses (120 mg every 12 hours)
- Maintenance dose: 120 mg orally once a day or 60 mg orally every 12 hours
- More severe infections: 120 mg orally every 12 hours
Comments:
- The IV maintenance dose for patients weighing at least 45 kg depends on the severity of the infection; the 200 mg dose may be given in 1 or 2 infusions.
- For patients at least 45 kg using a monohydrate formulation, the initial oral dose may be given in 2 or 4 divided doses (100 mg every 12 hours or 50 mg every 6 hours).
- When used in streptococcal infections, duration of therapy should be 10 days.
Uses:
- For the treatment of respiratory tract infections due to M pneumoniae
- For the treatment of respiratory tract infections due to H influenzae or Klebsiella species and upper respiratory infections due to S pneumoniae when bacteriological testing shows suitable susceptibility to this drug
Pediatric Infectious Diseases Society (PIDS) and IDSA Recommendations:
- Older than 7 years: 1 to 2 mg/kg orally twice a day
Comments:
- Recommended as an alternative for step-down therapy or mild infection due to M pneumoniae, C trachomatis, or C pneumoniae
- Current guidelines should be consulted for additional information.
Usual Pediatric Dose for Pneumonia
IV:
Less than 45 kg:
All patients with severe or life-threatening infections: 2.2 mg/kg IV every 12 hours
Patients older than 8 years with less severe infections:
- Initial dose: 4.4 mg/kg IV on the first day, given in 2 infusions
- Maintenance dose: 2.2 mg/kg IV once a day or 1.1 mg/kg IV twice a day
At least 45 kg:
- Initial dose: 200 mg IV on the first day, given in 1 or 2 infusions
- Maintenance dose: 100 to 200 mg/day IV
ORAL:
Most Products:
Less than 45 kg:
All patients with severe or life-threatening infections: 2.2 mg/kg orally every 12 hours
Patients older than 8 years with less severe infections:
- Initial dose: 4.4 mg/kg orally on the first day, given in 2 divided doses
- Maintenance dose: 2.2 mg/kg orally once a day or 1.1 mg/kg orally twice a day
At least 45 kg:
- Initial dose: 200 mg orally on the first day, given in 2 divided doses (100 mg every 12 hours)
- Maintenance dose: 100 mg orally once a day OR 50 mg orally every 12 hours
- More severe infections: 100 mg orally every 12 hours
Doryx(R) MPC:
Less than 45 kg:
All patients with severe or life-threatening infections: 2.6 mg/kg orally every 12 hours
Patients older than 8 years with less severe infections:
- Initial dose: 5.3 mg/kg orally on the first day, given in 2 divided doses
- Maintenance dose: 2.6 mg/kg orally once a day or 1.3 mg/kg orally twice a day
At least 45 kg:
- Initial dose: 240 mg orally on the first day, given in 2 divided doses (120 mg every 12 hours)
- Maintenance dose: 120 mg orally once a day or 60 mg orally every 12 hours
- More severe infections: 120 mg orally every 12 hours
Comments:
- The IV maintenance dose for patients weighing at least 45 kg depends on the severity of the infection; the 200 mg dose may be given in 1 or 2 infusions.
- For patients at least 45 kg using a monohydrate formulation, the initial oral dose may be given in 2 or 4 divided doses (100 mg every 12 hours or 50 mg every 6 hours).
- When used in streptococcal infections, duration of therapy should be 10 days.
Uses:
- For the treatment of respiratory tract infections due to M pneumoniae
- For the treatment of respiratory tract infections due to H influenzae or Klebsiella species and upper respiratory infections due to S pneumoniae when bacteriological testing shows suitable susceptibility to this drug
Pediatric Infectious Diseases Society (PIDS) and IDSA Recommendations:
- Older than 7 years: 1 to 2 mg/kg orally twice a day
Comments:
- Recommended as an alternative for step-down therapy or mild infection due to M pneumoniae, C trachomatis, or C pneumoniae
- Current guidelines should be consulted for additional information.
Usual Pediatric Dose for Upper Respiratory Tract Infection
IV:
Less than 45 kg:
All patients with severe or life-threatening infections: 2.2 mg/kg IV every 12 hours
Patients older than 8 years with less severe infections:
- Initial dose: 4.4 mg/kg IV on the first day, given in 2 infusions
- Maintenance dose: 2.2 mg/kg IV once a day or 1.1 mg/kg IV twice a day
At least 45 kg:
- Initial dose: 200 mg IV on the first day, given in 1 or 2 infusions
- Maintenance dose: 100 to 200 mg/day IV
ORAL:
Most Products:
Less than 45 kg:
All patients with severe or life-threatening infections: 2.2 mg/kg orally every 12 hours
Patients older than 8 years with less severe infections:
- Initial dose: 4.4 mg/kg orally on the first day, given in 2 divided doses
- Maintenance dose: 2.2 mg/kg orally once a day or 1.1 mg/kg orally twice a day
At least 45 kg:
- Initial dose: 200 mg orally on the first day, given in 2 divided doses (100 mg every 12 hours)
- Maintenance dose: 100 mg orally once a day OR 50 mg orally every 12 hours
- More severe infections: 100 mg orally every 12 hours
Doryx(R) MPC:
Less than 45 kg:
All patients with severe or life-threatening infections: 2.6 mg/kg orally every 12 hours
Patients older than 8 years with less severe infections:
- Initial dose: 5.3 mg/kg orally on the first day, given in 2 divided doses
- Maintenance dose: 2.6 mg/kg orally once a day or 1.3 mg/kg orally twice a day
At least 45 kg:
- Initial dose: 240 mg orally on the first day, given in 2 divided doses (120 mg every 12 hours)
- Maintenance dose: 120 mg orally once a day or 60 mg orally every 12 hours
- More severe infections: 120 mg orally every 12 hours
Comments:
- The IV maintenance dose for patients weighing at least 45 kg depends on the severity of the infection; the 200 mg dose may be given in 1 or 2 infusions.
- For patients at least 45 kg using a monohydrate formulation, the initial oral dose may be given in 2 or 4 divided doses (100 mg every 12 hours or 50 mg every 6 hours).
- When used in streptococcal infections, duration of therapy should be 10 days.
Uses:
- For the treatment of respiratory tract infections due to M pneumoniae
- For the treatment of respiratory tract infections due to H influenzae or Klebsiella species and upper respiratory infections due to S pneumoniae when bacteriological testing shows suitable susceptibility to this drug
Pediatric Infectious Diseases Society (PIDS) and IDSA Recommendations:
- Older than 7 years: 1 to 2 mg/kg orally twice a day
Comments:
- Recommended as an alternative for step-down therapy or mild infection due to M pneumoniae, C trachomatis, or C pneumoniae
- Current guidelines should be consulted for additional information.
Usual Pediatric Dose for Bronchitis
IV:
Less than 45 kg:
All patients with severe or life-threatening infections: 2.2 mg/kg IV every 12 hours
Patients older than 8 years with less severe infections:
- Initial dose: 4.4 mg/kg IV on the first day, given in 2 infusions
- Maintenance dose: 2.2 mg/kg IV once a day or 1.1 mg/kg IV twice a day
At least 45 kg:
- Initial dose: 200 mg IV on the first day, given in 1 or 2 infusions
- Maintenance dose: 100 to 200 mg/day IV
ORAL:
Most Products:
Less than 45 kg:
All patients with severe or life-threatening infections: 2.2 mg/kg orally every 12 hours
Patients older than 8 years with less severe infections:
- Initial dose: 4.4 mg/kg orally on the first day, given in 2 divided doses
- Maintenance dose: 2.2 mg/kg orally once a day or 1.1 mg/kg orally twice a day
At least 45 kg:
- Initial dose: 200 mg orally on the first day, given in 2 divided doses (100 mg every 12 hours)
- Maintenance dose: 100 mg orally once a day OR 50 mg orally every 12 hours
- More severe infections: 100 mg orally every 12 hours
Doryx(R) MPC:
Less than 45 kg:
All patients with severe or life-threatening infections: 2.6 mg/kg orally every 12 hours
Patients older than 8 years with less severe infections:
- Initial dose: 5.3 mg/kg orally on the first day, given in 2 divided doses
- Maintenance dose: 2.6 mg/kg orally once a day or 1.3 mg/kg orally twice a day
At least 45 kg:
- Initial dose: 240 mg orally on the first day, given in 2 divided doses (120 mg every 12 hours)
- Maintenance dose: 120 mg orally once a day or 60 mg orally every 12 hours
- More severe infections: 120 mg orally every 12 hours
Comments:
- The IV maintenance dose for patients weighing at least 45 kg depends on the severity of the infection; the 200 mg dose may be given in 1 or 2 infusions.
- For patients at least 45 kg using a monohydrate formulation, the initial oral dose may be given in 2 or 4 divided doses (100 mg every 12 hours or 50 mg every 6 hours).
- When used in streptococcal infections, duration of therapy should be 10 days.
Uses:
- For the treatment of respiratory tract infections due to M pneumoniae
- For the treatment of respiratory tract infections due to H influenzae or Klebsiella species and upper respiratory infections due to S pneumoniae when bacteriological testing shows suitable susceptibility to this drug
Pediatric Infectious Diseases Society (PIDS) and IDSA Recommendations:
- Older than 7 years: 1 to 2 mg/kg orally twice a day
Comments:
- Recommended as an alternative for step-down therapy or mild infection due to M pneumoniae, C trachomatis, or C pneumoniae
- Current guidelines should be consulted for additional information.
Usual Pediatric Dose for Rickettsial Infection
IV:
Less than 45 kg:
All patients with severe or life-threatening infections (e.g., RMSF): 2.2 mg/kg IV every 12 hours
Patients older than 8 years with less severe infections:
- Initial dose: 4.4 mg/kg IV on the first day, given in 2 infusions
- Maintenance dose: 2.2 mg/kg IV once a day or 1.1 mg/kg IV twice a day
At least 45 kg:
- Initial dose: 200 mg IV on the first day, given in 1 or 2 infusions
- Maintenance dose: 100 to 200 mg/day IV
ORAL:
Most Products:
Less than 45 kg:
All patients with severe or life-threatening infections: 2.2 mg/kg orally every 12 hours
Patients older than 8 years with less severe infections:
- Initial dose: 4.4 mg/kg orally on the first day, given in 2 divided doses
- Maintenance dose: 2.2 mg/kg orally once a day or 1.1 mg/kg orally twice a day
At least 45 kg:
- Initial dose: 200 mg orally on the first day, given in 2 divided doses (100 mg every 12 hours)
- Maintenance dose: 100 mg orally once a day OR 50 mg orally every 12 hours
- More severe infections: 100 mg orally every 12 hours
Doryx(R) MPC:
Less than 45 kg:
All patients with severe or life-threatening infections: 2.6 mg/kg orally every 12 hours
Patients older than 8 years with less severe infections:
- Initial dose: 5.3 mg/kg orally on the first day, given in 2 divided doses
- Maintenance dose: 2.6 mg/kg orally once a day or 1.3 mg/kg orally twice a day
At least 45 kg:
- Initial dose: 240 mg orally on the first day, given in 2 divided doses (120 mg every 12 hours)
- Maintenance dose: 120 mg orally once a day or 60 mg orally every 12 hours
- More severe infections: 120 mg orally every 12 hours
Comments:
- The IV maintenance dose for patients weighing at least 45 kg depends on the severity of the infection; the 200 mg dose may be given in 1 or 2 infusions.
- For patients at least 45 kg using a monohydrate formulation, the initial oral dose may be given in 2 or 4 divided doses (100 mg every 12 hours or 50 mg every 6 hours).
Uses: For the treatment of rickettsial infections including RMSF, typhus fever and the typhus group, Q fever, rickettsialpox, and tick fevers due to Rickettsia species
US CDC and AAP Recommendations:
- Less than 45 kg: 2.2 mg/kg orally or IV twice a day
- At least 45 kg: 100 mg orally or IV twice a day
Duration of Therapy:
- RMSF, ehrlichiosis: At least 3 days after fever subsides and until evidence of clinical improvement
- Anaplasmosis: 10 days
Comments:
- Recommended as drug of choice for all tickborne rickettsial diseases; recommended for patients of all ages
- Tickborne rickettsial diseases include RMSF due to R rickettsii, other spotted fever group rickettsioses due to R parkeri and Rickettsia species 364D, E chaffeensis ehrlichiosis (i.e., human monocytic ehrlichiosis), other ehrlichioses due to E ewingii and E muris-like agent, and anaplasmosis due to A phagocytophilum (i.e., human granulocytic anaplasmosis).
- The usual minimum duration of therapy for RMSF and ehrlichiosis is 5 to 7 days (total); severe/complicated disease may require longer therapy.
- According to some experts, typical duration of therapy for ehrlichiosis is 7 to 14 days.
- Current guidelines should be consulted for additional information.
Usual Pediatric Dose for Q Fever
IV:
Less than 45 kg:
All patients with severe or life-threatening infections (e.g., RMSF): 2.2 mg/kg IV every 12 hours
Patients older than 8 years with less severe infections:
- Initial dose: 4.4 mg/kg IV on the first day, given in 2 infusions
- Maintenance dose: 2.2 mg/kg IV once a day or 1.1 mg/kg IV twice a day
At least 45 kg:
- Initial dose: 200 mg IV on the first day, given in 1 or 2 infusions
- Maintenance dose: 100 to 200 mg/day IV
ORAL:
Most Products:
Less than 45 kg:
All patients with severe or life-threatening infections: 2.2 mg/kg orally every 12 hours
Patients older than 8 years with less severe infections:
- Initial dose: 4.4 mg/kg orally on the first day, given in 2 divided doses
- Maintenance dose: 2.2 mg/kg orally once a day or 1.1 mg/kg orally twice a day
At least 45 kg:
- Initial dose: 200 mg orally on the first day, given in 2 divided doses (100 mg every 12 hours)
- Maintenance dose: 100 mg orally once a day OR 50 mg orally every 12 hours
- More severe infections: 100 mg orally every 12 hours
Doryx(R) MPC:
Less than 45 kg:
All patients with severe or life-threatening infections: 2.6 mg/kg orally every 12 hours
Patients older than 8 years with less severe infections:
- Initial dose: 5.3 mg/kg orally on the first day, given in 2 divided doses
- Maintenance dose: 2.6 mg/kg orally once a day or 1.3 mg/kg orally twice a day
At least 45 kg:
- Initial dose: 240 mg orally on the first day, given in 2 divided doses (120 mg every 12 hours)
- Maintenance dose: 120 mg orally once a day or 60 mg orally every 12 hours
- More severe infections: 120 mg orally every 12 hours
Comments:
- The IV maintenance dose for patients weighing at least 45 kg depends on the severity of the infection; the 200 mg dose may be given in 1 or 2 infusions.
- For patients at least 45 kg using a monohydrate formulation, the initial oral dose may be given in 2 or 4 divided doses (100 mg every 12 hours or 50 mg every 6 hours).
Uses: For the treatment of rickettsial infections including RMSF, typhus fever and the typhus group, Q fever, rickettsialpox, and tick fevers due to Rickettsia species
US CDC and AAP Recommendations:
- Less than 45 kg: 2.2 mg/kg orally or IV twice a day
- At least 45 kg: 100 mg orally or IV twice a day
Duration of Therapy:
- RMSF, ehrlichiosis: At least 3 days after fever subsides and until evidence of clinical improvement
- Anaplasmosis: 10 days
Comments:
- Recommended as drug of choice for all tickborne rickettsial diseases; recommended for patients of all ages
- Tickborne rickettsial diseases include RMSF due to R rickettsii, other spotted fever group rickettsioses due to R parkeri and Rickettsia species 364D, E chaffeensis ehrlichiosis (i.e., human monocytic ehrlichiosis), other ehrlichioses due to E ewingii and E muris-like agent, and anaplasmosis due to A phagocytophilum (i.e., human granulocytic anaplasmosis).
- The usual minimum duration of therapy for RMSF and ehrlichiosis is 5 to 7 days (total); severe/complicated disease may require longer therapy.
- According to some experts, typical duration of therapy for ehrlichiosis is 7 to 14 days.
- Current guidelines should be consulted for additional information.
Usual Pediatric Dose for Cholera
IV:
Less than 45 kg:
All patients with severe or life-threatening infections: 2.2 mg/kg IV every 12 hours
Patients older than 8 years with less severe infections:
- Initial dose: 4.4 mg/kg IV on the first day, given in 2 infusions
- Maintenance dose: 2.2 mg/kg IV once a day or 1.1 mg/kg IV twice a day
At least 45 kg:
- Initial dose: 200 mg IV on the first day, given in 1 or 2 infusions
- Maintenance dose: 100 to 200 mg/day IV
ORAL:
Most Products:
Less than 45 kg:
All patients with severe or life-threatening infections: 2.2 mg/kg orally every 12 hours
Patients older than 8 years with less severe infections:
- Initial dose: 4.4 mg/kg orally on the first day, given in 2 divided doses
- Maintenance dose: 2.2 mg/kg orally once a day or 1.1 mg/kg orally twice a day
At least 45 kg:
- Initial dose: 200 mg orally on the first day, given in 2 divided doses (100 mg every 12 hours)
- Maintenance dose: 100 mg orally once a day OR 50 mg orally every 12 hours
- More severe infections: 100 mg orally every 12 hours
Doryx(R) MPC:
Less than 45 kg:
All patients with severe or life-threatening infections: 2.6 mg/kg orally every 12 hours
Patients older than 8 years with less severe infections:
- Initial dose: 5.3 mg/kg orally on the first day, given in 2 divided doses
- Maintenance dose: 2.6 mg/kg orally once a day or 1.3 mg/kg orally twice a day
At least 45 kg:
- Initial dose: 240 mg orally on the first day, given in 2 divided doses (120 mg every 12 hours)
- Maintenance dose: 120 mg orally once a day or 60 mg orally every 12 hours
- More severe infections: 120 mg orally every 12 hours
Comments:
- The IV maintenance dose for patients weighing at least 45 kg depends on the severity of the infection; the 200 mg dose may be given in 1 or 2 infusions.
- For patients at least 45 kg using a monohydrate formulation, the initial oral dose may be given in 2 or 4 divided doses (100 mg every 12 hours or 50 mg every 6 hours).
Use: For the treatment of cholera due to V cholerae
PAHO Recommendations: 2 to 4 mg/kg orally once
Comments:
- Recommended as alternative agent for the treatment of cholera in infants and children
- Current guidelines should be consulted for additional information.
Usual Pediatric Dose for Granuloma Inguinale
IV:
Less than 45 kg:
All patients with severe or life-threatening infections: 2.2 mg/kg IV every 12 hours
Patients older than 8 years with less severe infections:
- Initial dose: 4.4 mg/kg IV on the first day, given in 2 infusions
- Maintenance dose: 2.2 mg/kg IV once a day or 1.1 mg/kg IV twice a day
At least 45 kg:
- Initial dose: 200 mg IV on the first day, given in 1 or 2 infusions
- Maintenance dose: 100 to 200 mg/day IV
ORAL:
Most Products:
Less than 45 kg:
All patients with severe or life-threatening infections: 2.2 mg/kg orally every 12 hours
Patients older than 8 years with less severe infections:
- Initial dose: 4.4 mg/kg orally on the first day, given in 2 divided doses
- Maintenance dose: 2.2 mg/kg orally once a day or 1.1 mg/kg orally twice a day
At least 45 kg:
- Initial dose: 200 mg orally on the first day, given in 2 divided doses (100 mg every 12 hours)
- Maintenance dose: 100 mg orally once a day OR 50 mg orally every 12 hours
- More severe infections: 100 mg orally every 12 hours
Doryx(R) MPC:
Less than 45 kg:
All patients with severe or life-threatening infections: 2.6 mg/kg orally every 12 hours
Patients older than 8 years with less severe infections:
- Initial dose: 5.3 mg/kg orally on the first day, given in 2 divided doses
- Maintenance dose: 2.6 mg/kg orally once a day or 1.3 mg/kg orally twice a day
At least 45 kg:
- Initial dose: 240 mg orally on the first day, given in 2 divided doses (120 mg every 12 hours)
- Maintenance dose: 120 mg orally once a day or 60 mg orally every 12 hours
- More severe infections: 120 mg orally every 12 hours
Comments:
- The IV maintenance dose for patients weighing at least 45 kg depends on the severity of the infection; the 200 mg dose may be given in 1 or 2 infusions.
- For patients at least 45 kg using a monohydrate formulation, the initial oral dose may be given in 2 or 4 divided doses (100 mg every 12 hours or 50 mg every 6 hours).
Uses:
- For the treatment of granuloma inguinale due to K granulomatis
- For the treatment of lymphogranuloma venereum due to C trachomatis
AAP Recommendations:
8 years or older: 100 mg orally twice a day
Duration of Therapy:
- Granuloma inguinale: At least 3 weeks and until all lesions have completely healed
- Lymphogranuloma venereum: 21 days
Comments:
- Recommended as the drug of choice for granuloma inguinale; gentamicin may be added if no improvement is observed after several days.
- Recommended as the preferred therapy for lymphogranuloma venereum
- The patient's sexual partner(s) should also be evaluated/treated.
- Current guidelines should be consulted for additional information.
Usual Pediatric Dose for Lymphogranuloma Venereum
IV:
Less than 45 kg:
All patients with severe or life-threatening infections: 2.2 mg/kg IV every 12 hours
Patients older than 8 years with less severe infections:
- Initial dose: 4.4 mg/kg IV on the first day, given in 2 infusions
- Maintenance dose: 2.2 mg/kg IV once a day or 1.1 mg/kg IV twice a day
At least 45 kg:
- Initial dose: 200 mg IV on the first day, given in 1 or 2 infusions
- Maintenance dose: 100 to 200 mg/day IV
ORAL:
Most Products:
Less than 45 kg:
All patients with severe or life-threatening infections: 2.2 mg/kg orally every 12 hours
Patients older than 8 years with less severe infections:
- Initial dose: 4.4 mg/kg orally on the first day, given in 2 divided doses
- Maintenance dose: 2.2 mg/kg orally once a day or 1.1 mg/kg orally twice a day
At least 45 kg:
- Initial dose: 200 mg orally on the first day, given in 2 divided doses (100 mg every 12 hours)
- Maintenance dose: 100 mg orally once a day OR 50 mg orally every 12 hours
- More severe infections: 100 mg orally every 12 hours
Doryx(R) MPC:
Less than 45 kg:
All patients with severe or life-threatening infections: 2.6 mg/kg orally every 12 hours
Patients older than 8 years with less severe infections:
- Initial dose: 5.3 mg/kg orally on the first day, given in 2 divided doses
- Maintenance dose: 2.6 mg/kg orally once a day or 1.3 mg/kg orally twice a day
At least 45 kg:
- Initial dose: 240 mg orally on the first day, given in 2 divided doses (120 mg every 12 hours)
- Maintenance dose: 120 mg orally once a day or 60 mg orally every 12 hours
- More severe infections: 120 mg orally every 12 hours
Comments:
- The IV maintenance dose for patients weighing at least 45 kg depends on the severity of the infection; the 200 mg dose may be given in 1 or 2 infusions.
- For patients at least 45 kg using a monohydrate formulation, the initial oral dose may be given in 2 or 4 divided doses (100 mg every 12 hours or 50 mg every 6 hours).
Uses:
- For the treatment of granuloma inguinale due to K granulomatis
- For the treatment of lymphogranuloma venereum due to C trachomatis
AAP Recommendations:
8 years or older: 100 mg orally twice a day
Duration of Therapy:
- Granuloma inguinale: At least 3 weeks and until all lesions have completely healed
- Lymphogranuloma venereum: 21 days
Comments:
- Recommended as the drug of choice for granuloma inguinale; gentamicin may be added if no improvement is observed after several days.
- Recommended as the preferred therapy for lymphogranuloma venereum
- The patient's sexual partner(s) should also be evaluated/treated.
- Current guidelines should be consulted for additional information.
Usual Pediatric Dose for Malaria Prophylaxis
8 years or older:
Most products: 2 mg/kg orally once a day
Maximum dose: 100 mg/dose
Doryx(R) MPC: 2.4 mg/kg orally once a day
- At least 45 kg: 120 mg orally once a day
Comments:
- Prophylaxis should start 1 to 2 days before travel to endemic area; should continue daily while in malarious areas and for 4 weeks after leaving such areas
- Prophylaxis with this drug should not exceed 4 months.
- According to some manufacturers, patients weighing at least 45 kg should receive the adult dose.
Use: For prophylaxis of malaria due to P falciparum in short-term travelers (less than 4 months) to areas with chloroquine and/or pyrimethamine-sulfadoxine resistant strains
US CDC Recommendations:
8 years or older: 2.2 mg/kg orally once a day
Maximum dose: 100 mg/dose
Comments:
- Recommended for prophylaxis in all areas
- Not recommended for use during pregnancy or in patients younger than 8 years.
- Current guidelines should be consulted for additional information.
Usual Pediatric Dose for Malaria
US CDC Recommendations:
8 years or older:
Uncomplicated malaria: 2.2 mg/kg orally every 12 hours for 7 days
Maximum dose: 100 mg/dose
Severe malaria:
- Less than 45 kg: 2.2 mg/kg orally or IV every 12 hours
- At least 45 kg: 100 mg orally or IV twice a day
Comments:
- With quinine, recommended for uncomplicated malaria due to chloroquine-resistant P falciparum
- With quinine and primaquine, recommended for uncomplicated malaria due to chloroquine-resistant P vivax
- With quinine, recommended for severe malaria
- Current guidelines should be consulted for additional information.
Usual Pediatric Dose for Plague
IV:
Less than 45 kg:
All patients with severe or life-threatening infections: 2.2 mg/kg IV every 12 hours
Patients older than 8 years with less severe infections:
- Initial dose: 4.4 mg/kg IV on the first day, given in 2 infusions
- Maintenance dose: 2.2 mg/kg IV once a day or 1.1 mg/kg IV twice a day
At least 45 kg:
- Initial dose: 200 mg IV on the first day, given in 1 or 2 infusions
- Maintenance dose: 100 to 200 mg/day IV
ORAL:
Most Products:
Less than 45 kg:
All patients with severe or life-threatening infections: 2.2 mg/kg orally every 12 hours
Patients older than 8 years with less severe infections:
- Initial dose: 4.4 mg/kg orally on the first day, given in 2 divided doses
- Maintenance dose: 2.2 mg/kg orally once a day or 1.1 mg/kg orally twice a day
At least 45 kg:
- Initial dose: 200 mg orally on the first day, given in 2 divided doses (100 mg every 12 hours)
- Maintenance dose: 100 mg orally once a day OR 50 mg orally every 12 hours
- More severe infections: 100 mg orally every 12 hours
Doryx(R) MPC:
Less than 45 kg:
All patients with severe or life-threatening infections: 2.6 mg/kg orally every 12 hours
Patients older than 8 years with less severe infections:
- Initial dose: 5.3 mg/kg orally on the first day, given in 2 divided doses
- Maintenance dose: 2.6 mg/kg orally once a day or 1.3 mg/kg orally twice a day
At least 45 kg:
- Initial dose: 240 mg orally on the first day, given in 2 divided doses (120 mg every 12 hours)
- Maintenance dose: 120 mg orally once a day or 60 mg orally every 12 hours
- More severe infections: 120 mg orally every 12 hours
Comments:
- The IV maintenance dose for patients weighing at least 45 kg depends on the severity of the infection; the 200 mg dose may be given in 1 or 2 infusions.
- For patients at least 45 kg using a monohydrate formulation, the initial oral dose may be given in 2 or 4 divided doses (100 mg every 12 hours or 50 mg every 6 hours).
Use: For the treatment of plague due to Y pestis
US CDC Recommendations:
- Less than 45 kg: 2.2 mg/kg orally or IV twice a day
- At least 45 kg: 100 mg orally or IV twice a day or 200 mg orally or IV once a day
Comments:
- In general, recommended as an alternative regimen for the treatment of plague
- IV therapy should be started as soon as plague suspected; may switch to oral therapy once patient improves
- Current guidelines should be consulted for additional information.
Usual Pediatric Dose for Plague Prophylaxis
US CDC Recommendations:
8 years or older:
- Less than 45 kg: 2.2 mg/kg orally twice a day
- At least 45 kg: 100 mg orally twice a day
Comments:
- Recommended as a preferred agent for postexposure prophylaxis in patients with known exposure to plague (e.g., close contact with pneumonic plague patient, direct contact with infected body fluids/tissues)
- Current guidelines should be consulted for additional information.
Usual Pediatric Dose for Tularemia
IV:
Less than 45 kg:
All patients with severe or life-threatening infections: 2.2 mg/kg IV every 12 hours
Patients older than 8 years with less severe infections:
- Initial dose: 4.4 mg/kg IV on the first day, given in 2 infusions
- Maintenance dose: 2.2 mg/kg IV once a day or 1.1 mg/kg IV twice a day
At least 45 kg:
- Initial dose: 200 mg IV on the first day, given in 1 or 2 infusions
- Maintenance dose: 100 to 200 mg/day IV
ORAL:
Most Products:
Less than 45 kg:
All patients with severe or life-threatening infections: 2.2 mg/kg orally every 12 hours
Patients older than 8 years with less severe infections:
- Initial dose: 4.4 mg/kg orally on the first day, given in 2 divided doses
- Maintenance dose: 2.2 mg/kg orally once a day or 1.1 mg/kg orally twice a day
At least 45 kg:
- Initial dose: 200 mg orally on the first day, given in 2 divided doses (100 mg every 12 hours)
- Maintenance dose: 100 mg orally once a day OR 50 mg orally every 12 hours
- More severe infections: 100 mg orally every 12 hours
Doryx(R) MPC:
Less than 45 kg:
All patients with severe or life-threatening infections: 2.6 mg/kg orally every 12 hours
Patients older than 8 years with less severe infections:
- Initial dose: 5.3 mg/kg orally on the first day, given in 2 divided doses
- Maintenance dose: 2.6 mg/kg orally once a day or 1.3 mg/kg orally twice a day
At least 45 kg:
- Initial dose: 240 mg orally on the first day, given in 2 divided doses (120 mg every 12 hours)
- Maintenance dose: 120 mg orally once a day or 60 mg orally every 12 hours
- More severe infections: 120 mg orally every 12 hours
Comments:
- The IV maintenance dose for patients weighing at least 45 kg depends on the severity of the infection; the 200 mg dose may be given in 1 or 2 infusions.
- For patients at least 45 kg using a monohydrate formulation, the initial oral dose may be given in 2 or 4 divided doses (100 mg every 12 hours or 50 mg every 6 hours).
Use: For the treatment of tularemia due to F tularensis
Working Group on Civilian Biodefense Recommendations:
- Less than 45 kg: 2.2 mg/kg orally or IV twice a day
- At least 45 kg: 100 mg orally or IV twice a day
Duration of Therapy:
- Postexposure prophylaxis: 14 days
- Treatment in a contained casualty setting: At least 14 days
- Treatment in a mass casualty setting: 14 to 21 days
Comments:
- Recommended as an alternative IV regimen for the treatment of tularemia in a contained casualty setting and for postexposure prophylaxis
- Recommended as a preferred oral regimen for the treatment of tularemia in a mass casualty setting and for postexposure prophylaxis
- If parenteral therapy is used initially, may switch to oral therapy when clinically indicated
- Current guidelines should be consulted for additional information.
Usual Pediatric Dose for Skin or Soft Tissue Infection
Less than 45 kg:
All patients with severe or life-threatening infections: 2.2 mg/kg IV every 12 hours
Patients older than 8 years with less severe infections:
- Initial dose: 4.4 mg/kg IV on the first day, given in 2 infusions
- Maintenance dose: 2.2 mg/kg IV once a day or 1.1 mg/kg IV twice a day
At least 45 kg:
- Initial dose: 200 mg IV on the first day, given in 1 or 2 infusions
- Maintenance dose: 100 to 200 mg/day IV
Comments:
- The maintenance dose for patients weighing at least 45 kg depends on the severity of the infection; the 200 mg dose may be given in 1 or 2 infusions.
- Not the drug of choice for any type of staphylococcal infection
Use: For the treatment of skin and soft tissue infections due to S aureus when bacteriological testing shows suitable susceptibility to this drug
IDSA Recommendations:
8 years or older:
- Up to 45 kg: 2 mg/kg orally every 12 hours
- Greater than 45 kg: 100 mg orally twice a day
Comments:
- Recommended for purulent cellulitis (cellulitis associated with purulent drainage/exudate without a drainable abscess) due to methicillin-resistant S aureus
- Current guidelines should be consulted for additional information.
Usual Pediatric Dose for Nongonococcal Urethritis
AAP Recommendations:
- Adolescents and children 8 years or older weighing at least 45 kg: 100 mg orally twice a day for 7 days
Comments:
- Recommended in combination with ceftriaxone
- The patient's sexual partner(s) should also be evaluated/treated.
- Current guidelines should be consulted for additional information.
Usual Pediatric Dose for Cervicitis
AAP Recommendations:
- Adolescents and children 8 years or older weighing at least 45 kg: 100 mg orally twice a day for 7 days
Comments:
- Recommended in combination with ceftriaxone
- The patient's sexual partner(s) should also be evaluated/treated.
- Current guidelines should be consulted for additional information.
Usual Pediatric Dose for Chlamydia Infection
AAP and US CDC Recommendations:
Adolescents and children 8 years or older: 100 mg orally twice a day for 7 days
- Alternatively for adolescents (delayed-release tablets): 200 mg orally once a day for 7 days
Comments:
- Recommended for uncomplicated anogenital tract infection due to C trachomatis
- The patient's sexual partner(s) should also be evaluated/treated.
- Current guidelines should be consulted for additional information.
Usual Pediatric Dose for Epididymitis - Sexually Transmitted
AAP and US CDC Recommendations:
- Adolescents: 100 mg orally twice a day for 10 days
Comments:
- With ceftriaxone, the recommended regimen for acute epididymitis most likely due to sexually transmitted chlamydia and gonorrhea
- The patient's sexual partner(s) should also be evaluated/treated.
- Current guidelines should be consulted for additional information.
Usual Pediatric Dose for Gonococcal Infection - Uncomplicated
US CDC Recommendations:
- Adolescents: 100 mg orally twice a day for 7 days
Comments:
- With ceftriaxone (or cefixime), recommended for uncomplicated infections of the cervix, urethra, or rectum as an alternative second antimicrobial in patients with azithromycin allergy
- The AAP recommends the same dose for patients 8 years or older weighing at least 45 kg.
- The patient's sexual partner(s) should also be evaluated/treated.
- Current guidelines should be consulted for additional information.
Usual Pediatric Dose for Lyme Disease - Arthritis
IDSA Recommendations:
8 years or older: 2 mg/kg orally twice a day
Maximum dose: 100 mg/dose
Duration of Therapy:
- Acrodermatitis chronica atrophicans: 21 days
- Cardiac disease: 14 to 21 days
- Erythema migrans: 10 to 21 days
- Lyme arthritis: 28 days
Comments:
- Recommended for the treatment of early localized or early disseminated Lyme disease associated with erythema migrans when specific neurologic manifestations or advanced atrioventricular heart block absent, uncomplicated Lyme arthritis in patients without clinical evidence of neurologic disease, patients with atrioventricular heart block and/or myopericarditis associated with early Lyme disease, and acrodermatitis chronica atrophicans
- A parenteral antibiotic (e.g., ceftriaxone) is recommended as initial treatment of patients hospitalized for cardiac monitoring; an oral regimen may be used for completion of therapy and for ambulatory patients.
- Current guidelines should be consulted for additional information.
Usual Pediatric Dose for Lyme Disease - Carditis
IDSA Recommendations:
8 years or older: 2 mg/kg orally twice a day
Maximum dose: 100 mg/dose
Duration of Therapy:
- Acrodermatitis chronica atrophicans: 21 days
- Cardiac disease: 14 to 21 days
- Erythema migrans: 10 to 21 days
- Lyme arthritis: 28 days
Comments:
- Recommended for the treatment of early localized or early disseminated Lyme disease associated with erythema migrans when specific neurologic manifestations or advanced atrioventricular heart block absent, uncomplicated Lyme arthritis in patients without clinical evidence of neurologic disease, patients with atrioventricular heart block and/or myopericarditis associated with early Lyme disease, and acrodermatitis chronica atrophicans
- A parenteral antibiotic (e.g., ceftriaxone) is recommended as initial treatment of patients hospitalized for cardiac monitoring; an oral regimen may be used for completion of therapy and for ambulatory patients.
- Current guidelines should be consulted for additional information.
Usual Pediatric Dose for Lyme Disease - Erythema Chronicum Migrans
IDSA Recommendations:
8 years or older: 2 mg/kg orally twice a day
Maximum dose: 100 mg/dose
Duration of Therapy:
- Acrodermatitis chronica atrophicans: 21 days
- Cardiac disease: 14 to 21 days
- Erythema migrans: 10 to 21 days
- Lyme arthritis: 28 days
Comments:
- Recommended for the treatment of early localized or early disseminated Lyme disease associated with erythema migrans when specific neurologic manifestations or advanced atrioventricular heart block absent, uncomplicated Lyme arthritis in patients without clinical evidence of neurologic disease, patients with atrioventricular heart block and/or myopericarditis associated with early Lyme disease, and acrodermatitis chronica atrophicans
- A parenteral antibiotic (e.g., ceftriaxone) is recommended as initial treatment of patients hospitalized for cardiac monitoring; an oral regimen may be used for completion of therapy and for ambulatory patients.
- Current guidelines should be consulted for additional information.
Usual Pediatric Dose for Lyme Disease
IDSA Recommendations:
8 years or older: 2 mg/kg orally twice a day
Maximum dose: 100 mg/dose
Duration of Therapy:
- Acrodermatitis chronica atrophicans: 21 days
- Cardiac disease: 14 to 21 days
- Erythema migrans: 10 to 21 days
- Lyme arthritis: 28 days
Comments:
- Recommended for the treatment of early localized or early disseminated Lyme disease associated with erythema migrans when specific neurologic manifestations or advanced atrioventricular heart block absent, uncomplicated Lyme arthritis in patients without clinical evidence of neurologic disease, patients with atrioventricular heart block and/or myopericarditis associated with early Lyme disease, and acrodermatitis chronica atrophicans
- A parenteral antibiotic (e.g., ceftriaxone) is recommended as initial treatment of patients hospitalized for cardiac monitoring; an oral regimen may be used for completion of therapy and for ambulatory patients.
- Current guidelines should be consulted for additional information.
Usual Pediatric Dose for Lyme Disease - Neurologic
IDSA Recommendations:
8 years or older: 2 to 4 mg/kg orally twice a day
Maximum dose: 200 mg/dose
Duration of therapy: 14 days (range: 10 to 28 days)
Comments:
- Recommended as the preferred regimen for the treatment of nervous system Lyme disease (including the following syndromes: meningitis, any neurologic syndrome with CSF pleocytosis, peripheral nerve [radiculopathy, diffuse neuropathy, mononeuropathy multiplex, cranial neuropathy; normal CSF])
- Recommended in early Lyme disease for patients intolerant of beta-lactam antibiotics with acute neurologic disease manifested by meningitis or radiculopathy
- Current guidelines should be consulted for additional information.
Usual Pediatric Dose for Pelvic Inflammatory Disease
US CDC Recommendations:
- Adolescents: 100 mg orally or IV every 12 hours
Comments:
- With other agents, recommended as part of a parenteral regimen or as part of an IM/oral regimen; also recommended as part of an alternative parenteral regimen
- This drug may be switched from IV to oral administration 24 to 48 hours after clinical improvement to complete 14 days of therapy.
- Current guidelines should be consulted for additional information.
Usual Pediatric Dose for STD Prophylaxis
AAP Recommendations:
8 years or older and not pregnant: 100 mg orally twice a day for 7 days
Comments:
- With ceftriaxone, recommended as prophylaxis after sexual assault for dual therapy for gonorrhea and chlamydia
- Current guidelines should be consulted for additional information.
Renal Dose Adjustments
Most formulations: No adjustment recommended.
40 mg capsule formulation: May need to adjust dose; however, no specific guidelines have been suggested.
Liver Dose Adjustments
Data not available
Precautions
Consult WARNINGS section for additional precautions.
Dialysis
Data not available
Comments:
- Dialysis does not alter the serum half-life of this drug.
Other Comments
Administration advice:
- Avoid rapid IV administration; infusion duration may vary with dose, but is generally 1 to 4 hours; infuse 100 mg dose (of a 0.5 mg/mL solution) over at least 1 hour.
- Do not inject IV solutions IM or subcutaneously; use caution to avoid extravasation.
- Only use IV therapy short-term when oral therapy is not indicated; switch to oral therapy as soon as clinically feasible.
- Continue therapy for at least 24 to 48 hours after symptoms/fever subside.
- Administer oral formulations with plenty of fluid in an upright position to reduce the risk of esophageal irritation and ulceration.
- For most oral products, administer with food or milk if gastric irritation occurs; absorption not significantly affected by food or milk.
- May carefully break up a delayed-release tablet and sprinkle the contents (delayed-release pellets) on a spoonful of applesauce (to be swallowed at once without chewing); do not crush or damage delayed-release pellets when breaking up the tablet.
- Do not chew or crush Doryx(R) MPC tablets; this product is not substitutable on a mg per mg basis with other oral products.
- According to some manufacturers: Swallow capsules whole; do not break, open, crush, dissolve, or chew.
- Administer the 40 mg capsule formulation and the 20 mg capsule/tablet formulation on an empty stomach, 1 hour before or 2 hours after a meal.
Storage requirements:
- IV: The manufacturer product information should be consulted regarding storage and stability of reconstituted and/or further diluted solutions; protect solution from direct sunlight and/or artificial light.
- Oral formulations: Store below 30C (86F); protect from light.
Reconstitution/preparation techniques:
- The manufacturer product information should be consulted.
- IV: Reconstitution and further dilution needed, resulting in concentrations of 0.1 to 1 mg/mL; concentrations below 0.1 mg/mL or above 1 mg/mL are not recommended.
IV compatibility:
- Compatible: Sterile Water for Injection; Sodium Chloride Injection, USP; 5% Dextrose Injection, USP; Ringers Injection, USP; Invert Sugar, 10% in Water; Lactated Ringers Injection, USP; Dextrose 5% in Lactated Ringers; Normosol-M(R) in D5-W (5% dextrose in water) (Abbott); Normosol-R(R) in D5-W (Abbott); Plasma-Lyte(R) 56 in 5%Dextrose (Travenol); Plasma-Lyte(R) 148 in 5% Dextrose (Travenol)
General:
- The usual dose and dosing frequency of this drug are different from other tetracyclines; side effects may occur more often if recommended dose exceeded.
- Therapeutic antibacterial serum activity generally persists 24 hours after recommended dose.
- Thrombophlebitis may occur if IV therapy prolonged.
- Incision and drainage or other surgical procedures may be indicated in addition to antibiotic therapy.
- Absorption of tetracyclines impaired by iron-, zinc-, calcium-, aluminum-, or magnesium-containing products (e.g., antacids, sucralfate, mineral supplements, buffered didanosine).
- If the oral suspension is not available, emergency doses may be prepared from the tablets. The US FDA website should be consulted for information regarding preparation of this drug for patients who cannot swallow tablets (only recommended during a declared emergency).
- The 40 mg capsule formulation has not been evaluated for treatment or prevention of infections; it should not be used for treatment of bacterial infection, antibacterial prophylaxis, or reduction/elimination of microorganisms associated with any bacterial infection.
Monitoring:
- General: Organ system studies (periodically during long-term therapy)
- Hematologic: Hematopoietic studies (periodically during long-term therapy)
- Hepatic: Hepatic studies (periodically during long-term therapy)
- Renal: Renal studies (periodically during long-term therapy)
Patient advice:
- Read the US FDA-approved patient labeling (Patient Information), if applicable.
- Drink plenty of fluids.
- Avoid missing doses and complete the entire course of therapy.
- Avoid or minimize exposure to natural or artificial sunlight; use sun protection (e.g., protective clothing, sunscreen) if sun exposure cannot be avoided. Stop therapy if phototoxicity occurs.
- Consult physician at once if watery and bloody stools (with or without stomach cramps and fever) develop.
- Do not use this drug if it is outdated or decomposed; discard this drug by the expiration date.
Frequently asked questions
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- Is doxycycline hydrochloride 100mg a sulfa based drug?
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