American Thoracic Society Quick-Reference GUIDELINES Apps
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Table 5. Antimicrobials for Treatment of CAP—continued Adult Dose Antimicrobial (Brand) Penicillins Amoxicillin (Amoxil ® Nafcillin (Unipen® Oxacillin (Bactocill ® , others) , others) , others) Penicillin G p.o. 500 mg q8h OR 875 mg q12h 1 g tid* i.v. i.v. (aqueous) i.v. Miscellaneous Aztreonam (Azactam® ) Clindamycin (Cleocin® Doxycycline (Vibramycin® Linezolid (Zyvox® ) Vancomycin (Vancocin® , 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 i.v. 15 mg/kg q12h > Clindamycin active against > Doxycycline active against strains of S. pneumoniae, H. influenzae, and atypical pathogens; generally well tolerated S. pneumoniae but not active against H. influenzae or atypical pathogens 1-2 g q4-6h 1-2 g q4-6h 4-24 million units/d (moderate-high dose) in divided doses 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 Dosage Form Comments > Penicillin G active against penicillin-susceptible strains of S. pneumoniae, but limited against other common pulmonary pathogens > 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.