SKIN - Simple Abscess, Furuncle, Carbuncle, Folliculitis (Staphylococcus aureus, Streptococcus sp.)

 

 

Dicloxacillin

(Dynapen®)

Generics available

Pregnancy: B; Lactation: Unk

 

Caps: 125 mg, 250 mg, 500 mg

Oral Susp: 62.5 mg/5 mL  

 

 

Children ≤ 40 kg: 25-50 mg/kg/day (max 2 g/day) in divided doses every 6 hours for 10-14 days.

 

62.5 mg/5 mL @ 25 mg/kg/day (double for 50 mg)

 

Food: Take 1 hour before or 2 hours after meals.

 

Important side effects: Bad taste, GI upset, vomiting, diarrhea.

10 kg (22 lb) = 1 tsp (5 mL) Q6H

15 kg (33 lb) = 1½ tsp (7.5 mL) Q6H

20 kg (44 lb) = 2 tsp (10 mL) Q6H

40 kg (88 lb) = Use adult dose.

 

Children ≥40 kg and Adult: 250-500 mg

PO four times daily for 10-14 days.

 

 

Cephalexin

(Keflex®)

Generics available

Pregnancy: B; Lactation: Unk

 

Tabs: 250 mg, 500 mg, 1 g

Caps: 250 mg, 500 mg

Oral Susp: 125 mg/5 mL, 250 mg/5 mL

-  

 

Children: 25-50 mg/kg/day (max 4 g/day) in divided doses two to four times daily for 10-14 days.

 

125 mg/5 mL @ 25 mg/kg/day (double for 50 mg/kg)

10 kg (22 lb) = ½ tsp (2.5 mL) Q6H

15 kg (33 lb) = ¾ tsp Q6H

 

250 mg/5 mL @ 25 mg/kg/day (double for 50 mg/kg)

20 kg (44 lb) = ½ tsp (2.5 mL) Q6H

40 kg (88 lb) = 1 tsp (5 mL) Q6H

>40 kg = Use adult dose.

 

Adult: 500 mg PO two to four times daily for 10-14 days.

 

 

Food: Take 1 hour before or 2 hours after meals. May take with food if GI upset occurs.

 

Important side effects: GI upset, diarrhea.

 

Reduce dose if renal disease

(CrCl <40 mL/min).

 

Amoxicillin/clavulanate

(Augmentin®)

Pregnancy: B; Lactation: Unk

 

Children: 40-45 mg amoxicillin component/kg/day (max 1600 mg/day) in divided doses two or three times daily for 7-14 days.

 

 

Food: Take with food to reduce diarrhea.

 

Important side effects: Diarrhea (common), nausea, rash.

 

Q12H Formulations:

Tabs: 500 mg/125 mg, 875 mg/125 mg

   

Chewable Tabs:

200 mg/28.5 mg, 400 mg/57 mg

 

Oral Susp: 200 mg/28.5 mg/5 mL, 400 mg/57 mg/5 mL

Q12H using 200 mg/5 mL susp

@ 45 mg/kg/day

9 kg (20 lb) = 1 tsp (5 mL) Q12H

13 kg (29 lb) = 1½ tsp (7.5 mL) Q12H

18 kg (40 lb) = 2 tsp (10 mL) Q12H

 

Q12H using 400 mg/5 mL susp @ 45 mg/kg/day

18 kg (40 lb) = 1 tsp (5 mL) Q12H

27 kg (59 lb) = 1½ tsp (7.5 mL) Q12H

35 kg (77 lb) = 2 tsp (10 mL) Q12H

>40 kg = Use adult dose (max 875 mg Q12H )

 

Adult: 500-875 mg twice daily for 7-14 days.

 

Note: Q12H dosing may improve compliance compared to Q8H dosing.

 

Use with caution in hepatic disease.

 

Reduce dose in renal disease

(CrCl <30 mL/min).

 

Clindamycin

A drug of choice for patients with penicillin or cephalosporin intolerance.

(Cleocin®)

Generics available

Pregnancy: B; Lactation: Unk

 

Caps: 75 mg, 150 mg, 300 mg

Oral Solution: 75 mg/5 mL

150 mg/10 mL

 

Children: Mild to Moderate: 10-15 mg/kg/day (max 1.8 g/day) PO in divided doses three or four times daily for 10-14 days.

 

Children: Severe: 16-25 mg/kg/day (max

1.8 g/day) in divided doses three or four times daily for 10-14 days.

 

75 mg/5 mL @ 10 mg/kg/day divided

10 kg (22 lb) = ½ tsp (2.5 mL) Q8H

20 kg (44 lb) = 1 tsp (5 mL) Q8H

30 kg (66 lb) = 1½ tsp (7.5 mL) Q8H

40 kg (88 lb) = 2 tsp (10 mL) Q8H

>40 kg = Use adult dose.

 

 

Food: May take with or without meals. Take with full glass of water to prevent esophagitis.

 

Important side effects: Diarrhea (may be severe), nausea.

 

May cause severe colitis. Encourage patient to report severe, persistent, or bloody diarrhea.

 

Adult: Mild to Moderate: 150-300 mg PO three to four times daily for 10-14 days.

 

Adult: Severe: 450 mg PO four times daily for 10-14 days.

 

 

 

 

Erythromycin estolate or base

A drug of choice for patients with penicillin or cephalosporin intolerance

(E-mycin®, Ilosone ®)

Generics available

Pregnancy: B; Lactation: Unsafe

 

Children: 20-40 mg/kg/day estolate (max 2 g/day) in two to four divided doses daily for 10-14 days.

 

125 mg/5 mL @ 20 mg/kg/day

4-6 kg (10-15 lb) = ½ tsp (2.5 mL) Q12H

7-11 kg (16-25 lb) = 1 tsp (5 mL) Q12H

 

Food: May take with or without meals.

 

Take with food if causes GI upset.

 

Important side effects: GI upset, hepatitis.

Estolate:

12-16 kg (26-35 lb) = 1½ tsp (7.5 mL)

 

Tabs: 500 mg

Q12H

 

 

Caps: 250 mg

250 mg/5 mL @ 20 mg/kg/day

 

Susp: 125 mg/5 mL and 250 mg/5 mL

250 mg/5 mL Q12H × 10 days -  

Base:

Tabs: 250 mg, 333 mg, 500 mg

Caps: 250 mg

500 mg PO Q6H × 10 days -  

 

17-25 kg = 1 tsp (5 mL) Q12H

26-37 kg = 1½ tsp (7.5 mL) Q12H

>38 kg = 500 mg Q12H

 

Adult: Erythromycin base or estolate 500 mg PO four times daily for 10-14 days.