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Community-Acquired Pneumonia

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Selecting a Treatment Regimen Table 5. Antimicrobials for Treatment of CAP— Antimicrobial (Brand) Fluoroquinolones Moxifloxacin (Avelox® ) Gemifloxacin (Factive® ) Ciprofloxacin (Cipro® ) Levofloxacin (Levaquin® ) Ketolides Telithromycin (Ketek® ) p.o. 800 mg qd > Active against S. pneumoniae (including multidrug- resistant isolates), H. influenzae, M. catarrhalis, and atypical C. pneumoniae and M. pneumoniae > Limited use due to safety issues—Contraindications: myasthenia gravis, history of hepatitis. Warnings: severe liver injury, visual disturbances, loss of consciousness. See PI for details. Macrolides Azithromycin (Zithromax® ) p.o. i.v. Clarithromycin (Biaxin® ) (Biaxin XL® ) Erythromycin (Ery-tab® , others) p.o. p.o. i.v. p.o. 500 mg qd 1st day, then 250 mg qd × 4 500 mg qd at least 2 d, then p.o. 500 mg qd to complete 7 to 10 d therapy 500 mg qd × 1, then 250 mg qd × 4 250-500 g q12h 500 mg q6h 500-1000 mg q6h; 250-500 mg q6-8h * 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. > Macrolides active against most common pathogens including atypical pathogens > Erythromycin poorly tolerated and less effective against H. influenzae i.v., p.o. 750 mg qd i.v., p.o. 750 mg qd* p.o. 320 mg qd i.v., p.o. 400 mg qd > Active against S. pneumoniae (including penicillin- resistant strains), H. influenzae, methicillin- susceptible S. aureus, and atypical pathogens > Excepting gemifloxacin, availability as p.o. and i.v. facilitates switching Dosage Form Adult Dose Comments continued

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