BRONCHOPULMONARY - Bronchitis, Acute (Streptococcus pneumoniae, Haemophilus influenzae, Moraxella catarrhalis) Comment: Most cases of acute bronchitis are caused by viral infection and do not require antibiotic therapy.
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Amoxicillin/clavulanate (Augmentin®) Pregnancy: B; Lactation: Consider Alt
Q12H Formulations: Tabs: 500 mg/125 mg, 875 mg/125 mg, 1000 mg/ 62.5 XR
Oral Susp: 125 mg /31.25/ 5 mL 250 mg /62.5/ 5 mL 200 mg/28.5 mg/5 mL 400 mg/57 mg/5 mL 600 mg/42.5 mg/ 5 mL
Chew: 200, 400 mg
Augmentin 600 ES: Amoxicillin 600mg /42.9 mg
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Children: 45 mg amoxicillin component/kg/day (max 1600 mg/day) every 12 hours for 5-7 days.
Q12H using 200 mg/5 mL susp @ 45 mg/kg/day 9 kg (20 lb) = 1 tsp (5 mL) Q12H 13 kg (29 lb) = 11/2 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) = 11/2 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 5-7 days.
Note: Q12H dosing may improve compliance compared to Q8H dosing.
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Food: Take with food to reduce diarrhea.
Important side effects: Diarrhea (common), nausea, rash.
Use with caution in hepatic disease. Reduce dose in renal disease (CrCl <30 mL/min). |
Azithromycin (Zithromax®) Pregnancy: B; Lactation: Unk
Tabs: 250 mg and Z-Pak 500mg Tri-Pak
Oral Susp: 100 mg/5 mL, 200 mg/5 mL |
Children >2 years: 12 mg/kg/day (max 500 mg) daily for 5 days.
100 mg/5 mL 10 kg (22 lb) = 11/4 tsp Q24H
200 mg/5 mL 20 kg (44 lb) = 11/4 tsp Q24H 30 kg (66 lb) = 13/4 tsp Q24H ³40 kg (88 lb) = 500 mg Q24H
Adolescent >16 years and Adult: Dispense one Z-Pak.
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Food: Oral suspension should be taken 1 hour before or 2 hours after food.
Tablets may be taken without regard to food.
Important side effects: Nausea, diarrhea, elevated LFTs. |
Clarithromycin (Biaxin, Biaxin XL®) Pregnancy: C; Lactation: Unk
Tabs: 250 mg, 500 mg
Extended Release Tab (XL): 500 mg
Oral Susp: 125 mg/5 mL, 250 mg/5 mL 250 mg/5 mL
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Children >6 months: 15 mg/kg/day (max 1 g/day) in divided doses twice daily for 7-10 days.
125 mg/5 mL 9 kg (20 lb) = 1/2 tsp (2.5 mL) Q12H 17 kg (37 lb) = 1 tsp (5 mL) Q12H
250 mg/5 mL 25 kg (55 lb) = 3/4 tsp Q12H 33 kg (73 lb) = 1 tsp (5 mL) Q12H
Adult: 500 mg PO twice daily or 1 g XL PO once daily for 7-10 days.
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Food: Extended release tablet with food. Others without regard to food. Important side effects: Nausea, drug interactions. |
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Erythromycin estolate or base (Ilosone®, E-mycin®, Ery-Tab®) Generics available Pregnancy: B; Lactation: Unsafe
Estolate: Tabs: 500 mg Caps: 250 mg Susp: 250 mg/5 mL, 400 mg/5 mL
Base: Tabs: 250 mg, 333 mg, 500 mg Caps: 250 mg |
Children: 20-40 mg/kg/day estolate (max 2 g/day) PO in two to four divided doses daily for 7-10 days.
125 mg/5 mL @ 20-40 mg/kg/day 4-6 kg (10-15 lb) = 1/2 tsp (2.5 mL) Q12H 7-11 kg (16-25 lb) = 1 tsp (5 mL) Q12H 12-16 kg (26-35 lb) = 11/2 tsp (7.5 mL) Q12H or 1 tsp (5 mL) Q8H 250 mg/5 mL
@ 20-40 mg/kg/day 17-25 kg (37-55 lb) = 1 tsp (5 mL) Q12H 26-37 kg (57-81 lb) = 11/2 tsp (7.5 mL) Q12H or 1 tsp (5 mL) Q8H ³38 kg (84 lb) = 500 mg Q12H Adult: Erythromycin base or estolate 250-500 mg PO four times daily for 7-10 days.
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Food: May take with or without meals. Take with food if causes GI upset.
Important side effects: GI upset, hepatitis. |
Trimethoprim/Sulfamethoxazole (Bactrim®, Septra®) Generics available Pregnancy: C; Lactation: Unsafe
Single Strength (SS)Tabs: 80 mg/400 mg
Double Strength (DS) Tabs: 160 mg/800 mg
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Children >2 months: 8-12 mg/kg/day TMP component (max 320 mg/day) in divided doses twice daily for 7-10 days.
8 mg/kg/day @ 40 mg/200 mg/5 mL 10 kg (22 lb) = 1 tsp (5 mL) Q12H 20 kg (44 lb) = 2 tsp (10 mL) or 1 SS Tab Q12H 30 kg (66 lb) = 3 tsp (15 mL) or 11/2 SS Tab Q12H 40 kg (88 lb) = 4 tsp (20 mL) or 2 SS Tabs or 1 DS Tab Q12H for 10 days.
Adult: 1 DS tablet PO twice daily for 7-10 days.
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Food: May take without regard to food. Encourage fluids.
Important side effects: Photosensitivity, rash.
Reduce dose in severe renal disease (CrCl <30 mL/min). |
Oral Susp: 40 mg/200 mg per 5 mL |
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Other Reasonable options:
Amoxicillin
Cephalosporins - broad spectrum
Doxycycline