Indications & Dose: ACTINOMYCOSIS IV Adult 50mg/kg/day 4-6 wk | CHOLANGITIS Acute IV Adult 2g q4h with gentamicin | COMMUNITY-ACQUIRED PNEUMONIA PO Child Neonate: <7 days: 30mg/kg BID, max 62.5mg, 7–21 days: 30mg/kg TID, max 62.5mg, 21–28 days: 30mg/kg QID, max 62.5mg, 1 month–1 yr: 62.5mg QID, 1–5 yr: 125mg QID, 5–12 yr: 250mg QID, 12–18 yr: 250–500mg QID | IV Child Inj/Inf: <7 days: 60mg/kg q12h, 7–21 days: 60mg/kg q8h, 21–28 days: 60mg/kg q6h, 1 month–18 yr: 25 mg/kg, max 500mg q6h | DIVERTICULITIS IV/IM Adult 2g q6h with metronidazole | ENDOCARDITIS Prophylactic therapy IV/IM Adult 2g single dose 30 mins before procedure Child 50mg/kg single dose 30 mins before procedure in patients at moderate risk undergoing certain GI, biliary tract or genitourinary tract surgery or instrumentation | ENTEROCOCCAL ENDOCARDITIS IV Adult 12g/day in 6 equally divided IV doses with gentamicin (1mg/kg IM or IV q8h) 4-6 wk Child Neonate: <7 days: 50mg/kg BID, 7–21 days: 50mg/kg TID, 21–28 days: 50mg/kg QID, 1 month–18 yr: 50 mg/kg q4-6h, max 2g q4h with gentamicin (1mg/kg IM or IV q8h) 4-6 wk | GASTROENTERITIS PO Adult 500mg q6h Child <40kg: 50-100mg/kg/day in equally divided doses q6h | LISTERIAL MENINGITIS IV Child Neonate: <7 days: 100mg/kg BID, 7–21 days: 100mg/kg TID, 21–28 days: 100mg/kg QID, 1 month–18 yr: 50 mg/kg q4-6h, max 2g q4h with another antibacterial | MENINGITIS IV/IM Adult 8-14g or 150-200mg/kg/day in equally divided doses q3-4h (initially via IV atleast 3 days then IM) | ORAL INFECT PO Child Neonate: <7 days: 30mg/kg BID, max 62.5mg, 7–21 days: 30mg/kg TID, max 62.5mg, 21–28 days: 30mg/kg QID, max 62.5mg, 1 month–1 yr: 62.5mg QID, 1–5 yr: 125mg QID, 5–12 yr: 250mg QID, 12–18 yr: 250–500mg QID | OTITIS MEDIA PO Child Neonate: <7 days: 30mg/kg BID, max 62.5mg, 7–21 days: 30mg/kg TID, max 62.5mg, 21–28 days: 30mg/kg QID, max 62.5mg, 1 month–1 yr: 62.5mg QID, 1–5 yr: 125mg QID, 5–12 yr: 250mg QID, 12–18 yr: 250–500mg QID | IV Child Inj/Inf: <7 days: 30mg/kg q12h, 7–21 days: 30mg/kg q8h, 21–28 days: 30mg/kg q6h, 1 month–18 yr: 25 mg/kg, max 500mg q6h | PERINATAL GROUP B STREPTOCOCCAL INFECT Prophylactic therapy IV Adult Initially 2g at the onset of labor/after membrane rupture, then 1g QID until delivery | RESPIRATORY TRACT INFECT PO Adult 250-500mg q6h Child <40kg: 25-50mg/kg/day in equally divided doses q6h | SEPTICEMIA IV Adult 8-14g or 150-200mg/kg/day in equally divided doses q3-4h (initially via IV atleast 3 days, then IM) | Severe IM Child Neonates <7 days: 50mg/kg in equally divided doses q12h, 7-28 days: 100mg/kg in equally divided doses q8h, 7-28 days: 150mg/kg in equally divided doses q8h with gentamicin | SEVERE INFECT IV/IM Adult 500mg q4–6h Child <10 yr: 250mg q4–6h | SINUSITIS PO Child Neonate: <7 days: 30mg/kg BID, max 62.5mg, 7–21 days: 30mg/kg TID, max 62.5mg, 21–28 days: 30mg/kg QID, max 62.5mg, 1 month–1 yr: 62.5mg QID, 1–5 yr: 125mg QID, 5–12 yr: 250mg QID, 12–18 yr: 250–500mg QID | IV Child Inj/Inf: <7 days: 30mg/kg q12h, 7–21 days: 30mg/kg q8h, 21–28 days: 30mg/kg q6h, 1 month–18 yr: 25 mg/kg, max 500mg q6h | SKIN/SKIN STRUCTURE INFECT PO Adult 250-500mg q6h Child <40kg: 25-50mg/kg/day in equally divided doses q6h | TYPHOID/PARATYPHOID FEVER Acute PO Adult 1-2g QID 2 wk (4-12 wk in carriers) | IM Child 10 mg/kg QID for 4-6 wk, max 250mg (for chronic carriers) | UNCOMPLICATED GONORRHEA Acute PO Adult 3.5g as single dose with 1g of oral probenecid Child > 45kg: 3.5g as single dose | URINARY TRACT INFECT PO Adult 500mg q6h Child Neonate: <7 days: 30mg/kg BID, max 62.5mg, 7–21 days: 30mg/kg TID, max 62.5mg, 21–28 days: 30mg/kg QID, max 62.5mg, 1 month–1 yr: 62.5mg QID, 1–5 yr: 125mg QID, 5–12 yr: 250mg QID, 12–18 yr: 250–500mg QID | IV Child Inj/Inf: <7 days: 30mg/kg q12h, 7–21 days: 30mg/kg q8h, 21–28 days: 30mg/kg q6h, 1 month–18 yr: 25 mg/kg, max 500mg q6h

Precautions: Renal impairment, asthmatic patients, long-term therapy

ADR: Serious: penicillin encephalopathy, skin rashes, pseudomembranous colitis, blood disorders, anaphylaxis, Others: diarrhea, nausea, vomiting, oral candidiasis

DDI: Serious Allopurinol causes skin reactions, Sulfasalazine/Atenolol concentration is reduced, Chloroquine reduces drug absorption

Diet: Before food

Monitor: Hypersensitivity reaction, oral/rectal candidiasis, hemorrhage, LFTs, RFT, CBC