American Thoracic Society Quick-Reference GUIDELINES Apps
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Selecting a Treatment Regimen Table 5. Antimicrobials for Treatment of CAP—continued Adult Dose 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), > 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 250 mg qd × 4 500 mg qd at least 2 d, then p.o. 500 mg qd to complete 7 to 10 d therapy day, then 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. 400 mg qd p.o. 320 mg qd i.v., p.o. 750 mg qd* i.v., p.o. 750 mg qd > Active against S. pneumoniae (including penicillin- resistant strains), > Excepting gemifloxacin, availability as p.o. and i.v. facilitates switching H. influenzae, methicillin- susceptible S. aureus, and atypical pathogens Dosage Form Comments H. influenzae, M. catarrhalis, and atypical C. pneumoniae and M. pneumoniae