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Community-Acquired Pneumonia

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Table 5. Antimicrobials for Treatment of CAP Antimicrobial (Brand) Amoxicillin/clavulanate (Augmentin® ) Dosage Form Adult Dose β-Lactam/β-lactamase inhibitors p.o. 500 mg q8h OR 875 mg q12h OR 2 g bid* (using the 1000 mg/62.5 mg extended-release tablet formulation) Ampicillin/sulbactam (Unasyn® ) Piperacillin/tazobactam (Zosyn® ) Carbapenems Ertapenem (Invanz® ) Imipenem/cilastatin (Primaxin® ) Meropenem (Merrem® ) Cephalosporins Cefotaxime (Claforan® ) Ceftriaxone (Rocephin® ) Cefpodoxime proxetil (Vantin® ) Cefprozil (Cefzil ® ) Cefuroxime axetil (Ceftin® ) Cefuroxime (Kefurox® i.v. 750 mg–1.5 g q8h , Zinacef ® Cefditoren pivoxil (Spectracef ® ) Cefepime (Maxipime® i.v. ) * 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. 1-2 g q12h ) p.o. 400 mg bid p.o. 250-500 mg q12h p.o. 250-500 mg q12h p.o. 200 mg q12h i.v., i.m. 1-2 g q24h i.v., i.m. 1-2 g q8h > Oral cephalosporins active against most S. pneumoniae and nearly all H. influenzae > Cefprozil and cefpodoxime more active against S. pneumoniae than cefuroxime > Cefotaxime and ceftriaxone active against S. pneumoniae, H. influenzae, and methicillin-susceptible S. aureus > All cephalosporins inactive against atypical pathogens i.v. > 50 kg: 1 g q8h < 50 kg: 20-40 mg/kg q8h i.v. 500 mg–1 g q8h i.v., i.m. 1 g qd > Ertapenem activity against S. pneumoniae similar to cefotaxime and ceftriaxone, less than imipenem against P. aeruginosa; inactive against atypical pathogens i.v. 3.375 g q6h OR 4.5 g q6h i.v. 1.5–3 g q6h > β-Lactams inactive against atypical pathogens > Amoxicillin-clavulanate active against most H. influenzae, methicillin- susceptible S. aureus and anaerobes but not against atypical pathogens Comments

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