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Community-Acquired Pneumonia

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Table 5. Antimicrobials for Treatment of CAP— Antimicrobial (Brand) Penicillins Amoxicillin (Amoxil ® Nafcillin (Unipen® Oxacillin (Bactocill ® , others) , others) i.v. , others) Penicillin G i.v. (aqueous) Miscellaneous Aztreonam (Azactam® ) Clindamycin (Cleocin® Doxycycline (Vibramycin® Linezolid (Zyvox® ) Vancomycin (Vancocin® i.v. 15 mg/kg q12h , others) i.v., i.m. 1-2 g q8-12h (moderately severe infection) 2 g q6-8h (severe, life- threatening infection) , others) , others) i.v., i.m. p.o. i.v. p.o. 600 mg q8h 150-450 mg q6-8h 200 mg i.v. day 1 in 1-2 doses, then 100 mg q12h 100 mg q12h i.v., p.o. 600 mg q12h > Clindamycin active against S. pneumoniae but not active against H. influenzae or atypical pathogens > Doxycycline active against strains of S. pneumoniae, H. influenzae, and atypical pathogens; generally well tolerated > Linezolid active against most Gram-positive bacteria including multidrug-resistant S. pneumoniae and S. aureus but lacks established activity against atypical pathogens * Dose recommended in IDSA/ATS GUIDELINES (2007). • See product labeling for complete prescribing information. NOTE. Choices should be modified on the basis of susceptibility test results and advice from local specialists. Refer to local references for appropriate doses. 4-24 million units/d (moderate-high dose) in divided doses q4-6h 1-2 g q4-6h p.o. 500 mg q8h OR 875 mg q12h 1 g tid* i.v. 1-2 g q4-6h > Amoxicillin preferred for p.o. treatment of susceptible strains of S. pneumoniae, but high doses required; lacks activity against atypical pathogens and β-lactamase producers > Penicillin G active against penicillin-susceptible strains of S. pneumoniae, but limited against other common pulmonary pathogens Dosage Form Adult Dose Comments continued

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