MOUTH - Parotitis (Staphylococcus aureus) Comment: Oral drug therapy may be appropriate for early or mild cases. More advanced cases may require surgical drainage ± parenteral antibiotics.
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) PO in divided doses every 6 hours for 10-14 days. 62.5 mg/5 mL @ 25 mg/kg/day (double for 50 mg) 10 kg (22 lb) = 1 tsp (5 mL) Q6H 15 kg (33 lb) = 1^1/2 tsp (7.5 mL) Q6H 20 kg (44 lb) = 2 tsp (10 mL) Q6H 40 kg (88 lb) = Use adult dose. Children ³40 kg and Adult: 500 mg PO four times daily for 10-14 days.	Food: Take 1 hour before or 2 hours after meals.  Important side effects: Bad taste, GI upset, vomiting, diarrhea.
Clindamycin (Cleocin^®) Generics available Pregnancy: B; Lactation: Unk Caps: 75 mg, 150 mg, 300 mg Oral Solution: 75 mg/5 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. Severe: 16-30 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 Q8H 10 kg (22 lb) = ^1/2 tsp (2.5 mL) Q8H 20 kg (44 lb) = 1 tsp (5 mL) Q8H 30 kg (66 lb) = 1^1/2 tsp (7.5 mL) Q8H 40 kg (88 lb) = 2 tsp (10 mL) Q8H >40 kg = Use adult dose. Adult: Mild to moderate: 150-300 mg PO three to four times daily for 10-14 days. Severe: 450 mg PO four times daily for 10-14 days.	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, bloody, or persistent diarrhea.
Amoxicillin/clavulanate Augmentin^® Pregnancy: B; Lactation: Unk 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	Dosing: Based on Amoxicillin Component Neonates and infants <3 months: 125 mg/5 mL suspension 30 mg/kg/day in divided doses Q12H x 10 days Children ≥3 months up to 40 kg: Oral Suspension 25-45 mg/kg/day in divided doses Q12H using a Q12H formulation. 20-40 mg/kg/day in divided doses Q8H using a Q8H formulation. Multidrug-resistant S. pneumonia otitis media: 80-90 mg/kg/day in divided doses Q12H. Children ≥40 mg to Adult: 875mg PO Q12H x 10 days Q12H using 200 mg/5 mL susp or 200-mg chewable tablet @ 45 mg/kg/day 10 days 9 kg (20 lb) = 1 tsp (or tab) (5 mL) Q12H 13 kg (29 lb) = 1^1/2 tsp (or tab) (7.5 mL) Q12H 18 kg (40 lb) = 2 tsp (or tabs) (10 mL) Q12H Q12H using 400 mg/5 mL susp or 400-mg chewable tablet @ 45 mg/kg/day 10 days 18 kg (40 lb) = 1 tsp (or tab) (5 mL) Q12H 27 kg (59 lb) = 1^1/2 tsp (or tab) (7.5 mL) Q12H 35 kg (77 lb) = 2 tsp (or tabs) (10 mL) Q12H >40 kg = Use adult dose (max 875 mg Q12H )	Food: Advise taking with food. May administer with or without meals, however GI intolerance and diarrhea may be reduced if taken with meals. Side effects: Diarrhea (common), nausea, vomiting, rash, agitation, seizures, bleeding abnormalities, decreased WBC count, drug fever, superinfection. Caution: May cause nonallergic maculopapular rash, especially in patients with viral infection, mononucleosis, or acute lymphocytic leukemia. Use with caution in hepatic disease. Reduce dose in renal disease: CrCl 10-30 mL/min use a Q8H formulation Q12H CrCl <10 mL/min use a Q8H formulation Q24H

Section contributor: Jill Shelton Wagers, DMD, Boise, ID