GASTROINTESTINAL - Diarrhea, Giardia (protozoal)

 

 

Metronidazole

(Flagyl®)

Generics available

Pregnancy: B; Lactation: Unsafe

Tabs: 250 mg, 500 mg

 

Children: 15 mg/kg/day (max 300 mg/day) in divided doses three times daily for 5-10 days.

Adult: 250 mg three times daily for 7 days.

 

Food: Administer on empty stomach unless GI upset occurs, then with food.

 

Important side effects: Dizziness, headache, confusion, seizures, nausea, metallic taste, insomnia, paresthesias. May cause Disulfiram-like reaction - avoid alcohol.

 

 

GASTROINTESTINAL - Diarrhea (Salmonella typhi)

 

 

Ciprofloxacin

(Cipro®)

Pregnancy: C; Lactation: Unsafe

 

Tabs: 250 mg, 500 mg, 750 mg     

 

³ 18 and Adult: 500 mg PO twice daily for 5-7 days.

 

Food: Take on empty stomach 1 hour before or 2 hours after a meal. May take with food if it causes GI upset, but avoid large amounts of dairy products. May take 2 hours before or 6 hours after sucralfate, antacids, aluminum, magnesium, calcium, zinc, iron, sucralfate, vitamins, or mineral supplements.

 

 

 

Important side effects: Photosensitivity, dizziness.

 

Reduce dose in renal disease (CrCl <50 /min).

 

 

Azithromycin

(Zithromax®)

Pregnancy: B; Lactation: Unk

 

Tabs: 250 mg 

 

 

Adult: 1,000 mg PO once, then 500 mg PO once daily for 6 days.

 

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.

 

 

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 –

 

Susp: 40 mg/200 mg/5 mL

*Resistance may be increasing.

 

Children: 6-12mg/kg/day (trimethoprim component, max 320 mg/day) in divided

doses two time daily for 5-7 days.

 

40 mg/200 mg/5 mL @ 8 mg/kg/day

10 kg (22 lb) 5 mL Q12H

20 kg (44 lb) 10 mL or 1 SS Tablet Q12H

30 kg (66 lb) 15 mL Q12H 1½ SS Tablet Q12H

40 kg (88 lb) 20 mL or 2 SS Tab or 1 Septra DS Q12H

 

Adult: 1 DS tablet PO twice daily for 5-7 days.

 

 

 

Food: May take without regard to food. Encourage fluids.

 

Important side effects: Photosensitivity,

rash.

 

Reduce dose in renal disease (CrCl <30 mL/min).

 

 

 

GASTROINTESTINAL - Diarrhea, Staphylococcus aureus Antibiotic treatment not recommended

 

 

Metronidazole

(Flagyl®)

Pregnancy: B; Lactation: Unsafe

 

Children: 35-50 mg/kg/day (max 750 mg/dose) in divided doses three times daily for 5-10 days.

Food: Administer on empty stomach unless GI upset occurs, then with food.

Tabs: 250 mg, 375 mg, 500 mg

Flagyl ER: 750 mg -   

Adult: 750 mg three times daily for 5-10 days.

Important side effects: Dizziness, headache, confusion, seizures, nausea, metallic taste, insomnia, paresthesias. May cause Disulfiram-like reaction - avoid alcohol.

 

 

GASTROINTESTINAL - Diarrhea, Campylobacter jejuni

 

 

Ciprofloxacin

(Cipro®) Pregnancy: C; Lactation: Unsafe

 

Tabs: 250 mg, 500 mg, 750 mg -    *Resistance is increasing.

 

³ 18 and Adult: 500 mg PO twice daily for 3-5 days.

 

Food: Take on empty stomach 1 hour before or 2 hours after a meal. May take with food if it causes GI upset, but avoid large amounts of dairy products. May take 2 hours before or 6 hours after sucralfate, antacids, aluminum, magnesium, calcium, zinc, iron, sucralfate, vitamins, or mineral supplements.

 

Important side effects: Photosensitivity, dizziness.

 

Reduce dose in renal disease (CrCl <50 mL/min).

 

 

Azithromycin

(Zithromax®)

Pregnancy: B; Lactation: Unk

 

Tabs: 250 mg    

 

Adult: 500 mg PO once daily for 3 days.

 

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.

 

 

Erythromycin Base

(E-Mycin®, Ery-Tab®)

Pregnancy: B; Lactation: Safe

 

Estolate: Tabs: 500 mg  

Caps: 250 mg   

Susp: 125 mg/5 mL, 250 mg/5 mL   

Oral Drops: 100 mg/mL

 

Base:

Tabs: 250 mg, 333 mg, 500 mg

Caps: 250 mg

 

Children: 30-50 mg/kg/day (max 2000 mg/day) in divided doses four times 5-7 days.

 

200 mg/tsp @ 50 mg/kg/day

4-6 kg (10-15 lb) = ¼ tsp Q6H

7-11 kg (16-25 lb) = × tsp (2.5 mL) Q6H

11-22 kg (26-50 lb) = 1 tsp (5 mL) Q6H

23-45 kg (51-100 lb) = 1½ tsp (7.5 mL) Q6H

>100 lb = Use adult dose.

 

Children <6 years: 125 mg PO three times daily 10-14 days

.

Adult: 250-500 mg PO four times daily for 5-7 days.

 

 

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

 

Important side effects: Diarrhea, nausea, vomiting, headache, abdominal pain, dizziness, elevated LFTs, superinfection, rash, hearing loss, cardiac arrthythmias.