FACE - Sinusitis - Acute, Mild to Moderate (Streptococcus pneumoniae, Haemophilus influenzae, Moraxella catarrhalis) >90% of acute sinusitis is viral in nature
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Amoxicillin (Amoxil®) Pregnancy: B; Lactation: Unk |
Children: 45-90 mg/kg/day (max 1500 mg/day) in divided doses three times daily for 10-14 days. 250 mg/5 mL at 90 mg/kg/day
8 kg (18 lb) = 1 tsp (5 mL) Q8H 17 kg (37 lb) = 2 tsp (10 mL) Q8H >17 kg = Use adult dose.
Adult: 500 mg PO three times daily for 10-14 days. |
Food: May take with or without meals.
Important side effects: Diarrhea and nausea. May cause nonallergic maculopapular rash.
Reduce dose if renal impairment (CrCl <30 mL/min). |
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Caps: 250 mg, 500 mg Tabs: 500 mg, 875 mg
Chewable Tabs: 125, 250 mg
Susp: 125 mg/5 mL, 250 mg/5 mL, 400 mg/5 mL
Oral drops: 50 mg/mL
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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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Neonates and infants <3 months: Use 125 mg/31.25 mg/5 mL suspension.
30 mg/kg/day in divided doses every 12 hours
Children ≥3 months up to 40 kg: 40-45 mg amoxicillin component/kg/day (max 1600 mg/day) in divided doses two or three times daily for 10-14 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) = 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 dosing (max 875 mg Q12H ).
Adult: 500-875 mg twice daily for 10-14 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. May cause nonallergic maculopapular rash.
Use with caution in hepatic disease.
Reduce dose in renal impairment (CrCl <30 mL/min). |
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Cefpodoxime (Vantin®) Pregnancy: B; Lactation: Unsafe
Tabs: 100, 200 mg
Oral Susp: 50 mg/5 mL, 100 mg/5 mL
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Children >5 months to 12 years:
10 mg/kg/day (max 400 mg) in divided doses twice daily for 10 days. 100 mg/5 mL @ 10 mg/kg/day 10 kg (22 lb) = 1 tsp (5 mL) Q24H 20 kg (44 lb) = 2 tsp (10 mL) Q24H 30 kg (66 lb) = 3 tsp Q24H
12 years to Adult: 200-400 mg twice daily for 10-14 days
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Food: Take tablet with food. Suspension may be taken without regard to food.
Important side effects: Diarrhea. |
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Cefuroxime axetil (Ceftin®) Pregnancy: B; Lactation: Unsafe
Tabs: 125 mg, 250 mg, 500 mg
Oral Suspension: 125 mg/5 mL, 250 mg/5 mL
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Children >3 months to 12 years: 30 mg/kg/day (max 1,000 mg/day) in divided doses twice daily for 10 days.
125 mg/5 mL @ 30 mg/kg/day 8 kg (18 lb) = 1 tsp (5 mL) Q12H 12.5 kg (27 lb) = 1½ tsp (7.5 mL) Q12H 17 kg (37 lb) = 2 tsp (10 mL) Q12H 25 kg (55 lb) = 3 tsp (15 mL) Q12H 33 kg (73 lb) = Use adult dose.
12 years to Adults: 250-500 mg PO twice daily for 7-14 days.
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Food: Take suspension with food. Tablets may be taken without regard to food. Important side effects: Nausea, vomiting, diarrhea. |
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Doxycycline Vibramycin® Generics available Pregnancy: D; Lactation: Unsafe
Caps: 50 mg 100 mg
Tabs: 100 mg
Powder for Oral Suspension: 25 mg/5 mL
Syrup: 50 mg/5 mL
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Children: 2-4 mg/kg/day (max 200 mg/day) in two divided doses.
Children ≥8 years and Adult: 50-100 mg twice daily.
Use in children <8 years old is generally not advised because tetracyclines can retard skeletal development and stain dental enamel. Doxycycline may have a role in some children <8 years old in certain tick-borne diseases. The dental risk is less than other tetracyclines and is related to duration of use.
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Food: May take with food if GI upset occurs. Take 1 hour before or 2 hours after antacids, iron, milk, or other dairy products. Take with full glass of water to minimize esophagitis.
Important side effects: Photosensitivity, use sunscreen. Esophagitis, take with full glass of water. May discolor fingernails. Rash, nausea, diarrhea, superinfection, hepatitis.
Outdated tetracyclines are toxic and should not be used.
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FACE - Sinusitis - Acute, Mild to Moderate with Beta-lactam Allergy (Streptococcus pneumoniae, Haemophilus influenzae, Moraxella catarrhalis)
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Azithromycin (Zithromax®) Pregnancy: B; Lactation: Unk
Tabs: 250 mg Z-Pak Tri-Pak
Oral Suspension: 100 mg/5 mL, 200 mg/5 mL
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Children ≥6 months: 10 mg/kg/day (max 500 mg) daily × 1 day, then 5 mg/kg/day (max 250 mg) daily × 4 days.
100 mg/5 mL 10 kg (22 lb) = 1 tsp (5 mL)/day × 1 day, then ½ tsp (2.5 mL) daily for days 2-5.
200 mg/5 mL 20 kg (44 lb) = 1 tsp (5 mL)/day × 1 day, then ½ tsp (2.5 mL) daily for days 2-5. 30 kg (66 lb) = 1.5 tsp/day × 1 day, then ¾ tsp daily for days 2-5.
Adult: Dispense one Z-Pak.
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Food: Suspension, 1 hour before or 2 hours after food. Tablets, without regard to food.
Important side effects: Nausea, diarrhea, elevated LFTs. |
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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 |
Children ≥6 months: 15 mg/kg/day (max 1,000 mg/day) in divided doses twice daily for 10-14 days.
125 mg/5 mL @ 15 mg/kg/day 9 kg (20 lb) = ½ tsp (2.5 mL) Q12H 17 kg (37 lb) = 1 tsp (5 mL) Q12H 250 mg/5 mL @ 15 mg/kg/day 17 kg (37 lb) = ½ tsp (2.5 mL) Q12H 25 kg (55 lb) = ¾ 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 10-14 days.
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Food: Extended release tablet with food. Others without regard to food. Important side effects: Nausea. |
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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
Oral Susp: 125 mg/5 mL 250 mg/5 mL
Base: Tabs: 250 mg, 333 mg, 500 mg
Caps: 250 mg, 500 mg PO
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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 12-16 kg (26-35 lb) = 1½ tsp (7.5 mL) Q12H
250 mg/5 mL @ 20 mg/kg/day 17-25 kg (37-55 lb) = 1 tsp (5 mL) Q12H 26-37 kg (57-81 lb) = 1½ tsp (7.5 mL) Q12H >38 kg (83 lb) = 500 mg Q12H
Adult: Erythromycin base or estolate 500 mg PO four times daily for 10-14 days. |
Food: May take with or without meals. Take with food if causes GI upset.
Important side effects: GI upset, hepatitis. |
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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
Oral Susp: 40 mg/200 mg per 5 mL
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Children >2 months: 8-10 mg/kg/day TMP component (max 320 mg/day) in divided doses twice daily for 10-14 days.
8-10 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 1½ SS Tab Q12H 40 kg (88 lb) = 4 tsp (20 mL) or 2 SS Tabs or 1 DS Tab Q12H
Adult: 1 DS Tab PO twice daily for 10-14 days. |
Food: May take without regard to food. Encourage fluids.
Important side effects: Photosensitivity, rash.
Reduce dose if renal impairment (CrCl <30 mL/min). |
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FACE - Sinusitis - Acute - Failed Therapy or Antibiotic Use in the Past 4-6 Weeks (Streptococcus pneumoniae, Haemophilus influenzae, Moraxella catarrhalis)
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Levofloxacin (Levaquin®) Pregnancy: C; Lactation: Unsafe
Tabs: 250 mg, 500 mg
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Adult: 500 mg PO once daily for 10-14 days.
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Food: May take with or without meals. Do not take within 2 hours of antacids, magnesium, calcium supplements, zinc, aluminum, sucralfate, vitamins, or minerals (iron or zinc).
Important side effects: Photosensitivity, dizziness.
Reduce dose if renal impairment (CrCl <50 mL/min).
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