Medication | Dose | Route | Usual maximum daily dose | Potential adverse effects and target dose ranges |
Azithromycin | - 5 to 10 mg/kg per day in 1 dose for daily dosing
- 10 mg/kg per day in 1 dose for 3 times per week dosing
| Oral | - Daily: 300 mg/day
- 3 times per week: 500 mg/day
| - Prolongation of the QT interval; nausea; vomiting; diarrhea; decreased hearing; dizziness; hepatitis; phlebitis (IV)
|
Clarithromycin* | - 15 to 30 mg/kg per day divided in 2 doses (for daily or 3 times per week dosing)¶
| Oral | | - Prolongation of the QT interval; nausea; vomiting; diarrhea; taste disturbance; decreased hearing; hepatitisΔ ; anterior uveitisΔ ; arthralgiaΔ ; granulocytopeniaΔ ; inhibits hepatic drug metabolism causing significant drug-drug interactions (particularly with rifamycins)
|
Ethambutol* | - 15 mg/kg per day in 1 dose for daily dosing
- 25 mg/kg per day in 1 dose for 3 times per week dosingΔ
| Oral | - Daily: 1 g/day
- 3 times per week: 2.5 g/day
| - Optic neuritis (usually reversible)◊; red-green color blindness§; gastrointestinal disturbances; hypersensitivity
|
Rifabutin*¥ | - 10 to 20 mg/kg per day in 1 dose (for daily or 3 times per week dosing)
| Oral | | - Orange discoloration of secretions (may stain soft contact lenses), urine, and stool; gastrointestinal disturbance; hepatitisΔ; "flu-like" syndrome; thrombocytopenia; renal failure; myalgia; arthralgiaΔ; granulocytopeniaΔ; anterior uveitisΔ
|
Rifampin (rifampicin)¥ | - 15 to 20 mg/kg per day in 1 dose (for daily or 3 times per week dosing)
| Oral | - Children weighing <50 kg: 450 mg/day
- Children weighing ≥50 kg: 600 mg/day
| - Orange discoloration of secretions (may stain soft contact lenses), urine, and stool; gastrointestinal disturbance; hepatitis; "flu-like" syndrome; thrombocytopenia; renal failure; induces hepatic drug metabolism causing multiple significant drug-drug interactions
|
Medications that may be added if Mycobacterium tuberculosis cannot be excluded |
Isoniazid | - 10 to 15‡ mg/kg per day in 1 dose
| Oral, IM | | - Mild hepatic enzyme elevation; hepatitis‡; peripheral neuritis; hypersensitivity (fever, rash); diarrhea and gastric irritation (caused by vehicle in syrup)
- Pyridoxine supplementation of 1 to 2 mg/kg per day (up to 50 mg/day) is suggested to prevent peripheral neuropathy in exclusively breastfed infants, children and adolescents on meat- and milk-deficient diets, children with nutritional deficiencies, children and adolescents with symptomatic HIV infection, and pregnant adolescents
|
Pyrazinamide* | - 30 to 40 mg/kg per day for daily dosing
- 50 mg/kg per day for twice weekly dosing
| Oral | | - Arthralgia; gastrointestinal
|