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.

 

 

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

 

 

 

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.

 

 

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.

 

 

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

    

 

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.

 

 

Food: Extended release tablet with food. Others without regard to food. Important side effects: Nausea, drug interactions.

 

 

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.

 

 

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

 

 

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.

 

 

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

 

 

Other Reasonable options:

Amoxicillin

Cephalosporins - broad spectrum

Doxycycline