Version June 2024
| Adults | Children | |
Patients with either:
| ||
| A third- or fourth-generation cephalosporin (one of the following): | ||
| Ceftriaxone | 1 to 2 g IV every 24 hours | 50 to 75 mg/kg IV every 24 hours (maximum 2 g/day) |
| Cefotaxime | 2 g IV every 6 to 8 hours | 50 mg/kg IV every 6 to 8 hours (maximum 8 g/day) |
| Ceftazidime | 1 to 2 g IV every 8 hours | 50 mg/kg IV every 8 hours (maximum 6 g/day) |
| Cefepime | 2 g IV every 12 hours | 50 mg/kg IV every 12 hours (maximum 4 g/day) |
| plus either | ||
| A tetracycline (preferred; one of the following)¶ | ||
| Doxycycline | 100 mg IV or orally every 12 hours | 2.2 mg/kg IV or orally every 12 hours (maximum 100 mg/dose) |
| Minocycline | 100 mg IV or orally every 12 hours | 2 mg/kg IV or orally every 12 hours (maximum 100 mg/dose) |
| or | ||
| A fluroquinolone (alternative agent; one of the following)Δ◊ | ||
| Ciprofloxacin | 400 mg IV twice daily or 500 to 750 mg orally every 12 hours | IV: 10 mg/kg every 12 hours (maximum 400 mg per/dose) Oral: 10 to 20 mg/kg every 12 hours (maximum 750 mg/dose) |
| Levofloxacin | 750 mg IV or orally once daily | 6 months to 5 years: 8 to 10 mg/kg IV or orally every 12 hours (maximum 750 mg/day) ≥5 years: 10 mg/kg IV or orally once daily (maximum 750 mg/day) |
| Patients with mild wound infection, in the absence of risk factors for severe disease* | ||
| A tetracycline (preferred; one of the following)¶ | ||
| Doxycycline | 100 mg orally twice daily | 2.2 mg/kg orally every 12 hours (maximum 100 mg/dose) |
| Minocycline | 100 mg orally twice daily | 2 mg/kg orally every 12 hours (maximum 100 mg/dose) |
| or | ||
| A fluroquinolone (alternative agent; one of the following)Δ◊ | ||
| Ciprofloxacin | 500 mg orally twice daily | 10 mg/kg orally every 12 hours (maximum 500 mg/dose) |
| Levofloxacin | 750 mg orally once daily | 6 months to 5 years: 8 to 10 mg/kg orally every 12 hours (maximum 750 mg/day) ≥5 years: 10 mg/kg orally once daily (maximum 750 mg/day) |
IV: intravenously.
* Risk factors for severe disease include alcoholic cirrhosis, underlying liver disease including chronic hepatitis due to alcohol or other causes, moderate to heavy alcohol use (in the absence of documented liver disease), hereditary hemochromatosis, and chronic diseases (such as diabetes, thalassemia, renal failure, and immunocompromising conditions).
¶ Doxycycline can be administered for short durations (≤21 days) without regard to patient age[1].
Δ For patients who are not able to tolerate tetracyclines, a fluoroquinolone may be used as an alternative agent; we prefer ciprofloxacin, given limited clinical data for other fluoroquinolones.
◊ Fluoroquinolones should not be used routinely as first-line agents in children <18 years of age except in specific conditions for which there are no alternative agents and the drug is known to be effective[2].Includes data from: Lexicomp Online. Copyright © 1978-2024 Lexicomp, Inc. All Rights Reserved.
References:آیا می خواهید مدیلیب را به صفحه اصلی خود اضافه کنید؟
