Drug List Home Antibacterial Sensitivity Chart

Azithromycin

Combinations; Azithromycin/ Fluconazole/ Secnidazole- See below

Dosage;

500mg once daily for 3 days or 500mg on first day then 250mg once daily for 4 days;

Child over 6 months 10mg/kg once daily for 3 days

or 10mg/kg on day 1 then 5mg/kg/day, day 2 to5 or (Zmax):

60mg/kg PO once as a single dose; not to exceed 2g/dose;

body-weight 15-25kg, 200mg once daily for 3 days;

body-weight 26-35kg, 300mg once daily for 3 days;

body-weight 36-45kg, 400mg once daily for 3 days.

Uncomplicated genital chlamydial infections and non-gonococcal urethritis,

1g as a single dose.Lyme disease, typhoid, 500mg once daily for 7-10 days (7 days in typhoid).

Dosing: Adult

Note: Extended release suspension (Zmax®) is not interchangeable with immediate release formulations.

Use should be limited to approved indications.

All doses are expressed as immediate release azithromycin unless otherwise specified.

Bacterial sinusitis: Oral: 500 mg/day for a total of 3 days

Extended release suspension (Zmax®): 2 g as a single dose

Cat scratch disease (unlabeled use): Oral: >45.5 kg: 500 mg as a single dose, then 250 mg once daily for 4 days

Chancroid due to H. ducreyi: Oral: 1 g as a single dose (CDC, 2010)

Community-acquired pneumonia:

Oral: Extended release suspension (Zmax®): 2 g as a single dose

I.V.: 500 mg as a single dose for at least 2 days, follow I.V. therapy by the oral route with a single daily dose of 500 mg to complete a 7- to 10-day course of therapy.

Disseminated M. avium complex disease in patient with advanced HIV infection (unlabeled use): Oral:

Prophylaxis: 1200 mg once weekly (may be combined with rifabutin)

Treatment: 600 mg daily in combination with ethambutol 15 mg/kg

Gonococcal infection, uncomplicated (cervix, pharynx, rectum, urethra): Oral: 1 g as a single dose (in combination with a cephalosporin) (CDC, 2010)

Note: Monotherapy with azithromycin (1 g and 2 g) have been associated with resistance and/or treatment failure; use in combination with a cephalosporin (CDC, 2010). However, a single 2 g azithromycin dose is still an FDA-approved dose for gonococcal urethritis and cervicitis and also may be appropriate for treatment of a gonococcal infection in pregnant women who cannot tolerate a cephalosporin (CDC, 2010).

Granuloma inguinale (donovanosis): Oral: 1 g once a week for at least 3 weeks (and until lesions have healed) (CDC, 2010)

Mild-to-moderate respiratory tract, skin, and soft tissue infections: Oral: 500 mg in a single loading dose on day 1 followed by 250 mg/day as a single dose on days 2-5

Alternative regimen: Bacterial exacerbation of COPD: 500 mg/day for a total of 3 days

Pelvic inflammatory disease (PID): I.V.: 500 mg as a single dose for 1-2 days, follow I.V. therapy by the oral route with a single daily dose of 250 mg to complete a 7-day course of therapy.

Pertussis (CDC, 2005): Oral: 500 mg on day 1 followed by 250 mg/day on days 2-5 (maximum: 500 mg/day)

Prophylaxis against infective endocarditis (unlabeled use): Oral: 500 mg 30-60 minutes prior to the procedure. Note: American Heart Association (AHA) guidelines now recommend prophylaxis only in patients undergoing invasive procedures and in whom underlying cardiac conditions may predispose to a higher risk of adverse outcomes should infection occur. As of April 2007, routine prophylaxis for GI/GU procedures is no longer recommended by the AHA.

Prophylaxis against sexually-transmitted diseases following sexual assault: Oral: 1 g as a single dose (in combination with a cephalosporin and metronidazole) (CDC, 2010)

Urethritis/cervicitis: Oral: Due to C. trachomatis or M. genitalium: 1 g as a single dose

Dosing: Pediatric

(For additional information see "Azithromycin (systemic): Pediatric drug information")

Note: Extended release suspension (Zmax®) is not interchangeable with immediate release formulations. Use should be limited to approved indications. All doses are expressed as immediate release azithromycin unless otherwise specified.

Note: Adolescents ≥16 years: Refer to adult dosing.

Bacterial sinusitis: Children ≥6 months: Oral: 10 mg/kg once daily for 3 days (maximum: 500 mg/day)

Cat scratch disease (unlabeled use): Oral: <45.5 kg: 10 mg/kg as a single dose, then 5 mg/kg once daily for 4 days

Community-acquired pneumonia: Children ≥6 months: Oral: 10 mg/kg on day 1 (maximum: 500 mg/day) followed by 5 mg/kg/day once daily on days 2-5 (maximum: 250 mg/day)

Extended release suspension (Zmax®):

<75 lbs (34 kg): 60 mg/kg as a single dose; dose in mL is equal to the weight in lbs for patients <75 lbs (34 kg)

≥75 lbs (34 kg): Refer to adult dosing.

Disseminated M. avium (unlabeled use; CDC, 2009): Oral:

Treatment: 10-12 mg/kg/day (maximum: 500 mg)

Primary prophylaxis: 20 mg/kg (maximum: 1200 mg) once weekly (preferred) or alternatively, 5 mg/kg/day once daily (maximum: 250 mg/day)

Secondary prophylaxis: 5 mg/kg/day once daily (maximum: 250 mg/day) in combination with ethambutol, with or without rifabutin

Prophylaxis against infective endocarditis (unlabeled use): Oral: 15 mg/kg 30-60 minutes before procedure. Note: American Heart Association (AHA) guidelines now recommend prophylaxis only in patients undergoing invasive procedures and in whom underlying cardiac conditions may predispose to a higher risk of adverse outcomes should infection occur. As of April 2007, routine prophylaxis for GI/GU procedures is no longer recommended by the AHA.

Otitis media: Children ≥6 months: Oral:

1-day regimen: 30 mg/kg as a single dose (maximum dose: 1500 mg)

3-day regimen: 10 mg/kg once daily for 3 days (maximum: 500 mg/day)

5-day regimen: 10 mg/kg on day 1 (maximum: 500 mg/day) followed by 5 mg/kg/day once daily on days 2-5 (maximum: 250 mg/day)

Pharyngitis, tonsillitis: Children ≥2 years: Oral: 12 mg/kg/day once daily for 5 days (maximum: 500 mg/day)

Pertussis (CDC, 2005):

Children <6 months: 10 mg/kg/day for 5 day

Children ≥6 months: 10 mg/kg on day 1 (maximum: 500 mg/day) followed by 5 mg/kg/day once daily on days 2-5 (maximum: 250 mg/day)

Uncomplicated chlamydial urethritis or cervicitis (unlabeled use): Children ≥45 kg: 1 g as a single dose (CDC, 2010)

Dosing: Geriatric

Refer to adult dosing.

Dosing: Renal Impairment

Use caution in patients with GFR <10 mL/minute.

Poorly dialyzed; no supplemental dose or dosage adjustment necessary, including patients on intermittent hemodialysis, peritoneal dialysis, or continuous renal replacement therapy (eg, CVVHD).

Dosing: Hepatic Impairment

Use with caution due to potential for hepatotoxicity (rare). Specific guidelines for dosing in hepatic impairment have not been established