GASTROINTESTINAL - Diarrhea, Acute, Traveler’s, Mild to Severe (Shigella, E. coli, Salmonella)
|
||
Ciprofloxacin (Cipro®) Pregnancy: C; Lactation: Unsafe
Tabs: 250 mg, 500 mg, 750 mg Use with antimotility drug such as loperamide (Imodium®) if no fever or blood in stool. |
>18 and Adult, Mild to Moderate: 750 mg PO × 1 dose. ³18 and Adult, Severe: 500 mg twice daily × 3 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).
|
Levofloxacin (Levaquin®) Pregnancy: C; Lactation: Unsafe
Tabs: 250 mg, 500 mg - Use with antimotility drug such as loperamide (Imodium®) if no fever or blood in stool. |
>18 and Adult, Mild to Moderate: 500 mg PO × 1 dose.
>18 and Adult, Severe: 500 mg PO Q24H 3 days. |
Food: May take with or without meals. Do not take within 2 hours of antacids,magnesium, calcium supplements, aluminum, sucralfate, vitamins, or minerals (iron or zinc).
Important side effects: Photosensitivity, dizziness.
Reduce dose in renal disease (CrCl <50 mL/min).
|
Azithromycin Alternative for children and pregnant women.
(Zithromax®) Pregnancy: B; Lactation: Unk
Tabs: 250 mg and Z-Pak (500 mg × 1 day, then 250 mg daily
|
Children³ 6 months: 5-10 mg/kg/day (max 500 mg) once daily for 5 days.
100 mg/tsp @ 10 mg/kg/day 10 kg (22 lb) = 1 tsp (5 mL) once daily for 5 days.
200 mg/tsp @ 10 mg/kg/day 20 kg (44 lb) = 1 tsp (5 mL) Q24H 30 kg (66 lb) = 1½ tsp (7.5 mL) Q24H 40 kg (88 lb) = 2 tsp (10 mL) Q24H >50 kg (110 lb) = Use adult dose.
Adult, Mild to Moderate: 1,000 mg × 1dose.
Adult, Severe: 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. |
Oral Susp: 100 mg/5 mL, 200 mg/5 mL |
|
|
Trimethoprim/Sulfamethoxazole (Bactrim®, Septra®) Generics available Pregnancy: C; Lactation: Unsafe |
Children: 6-12 mg/kg/day (trimethoprim component, max 320 mg/day) in divided doses two times daily for 3-5 days.
40 mg/200 mg/5 mL @ 8 mg/kg/day
|
Food: May take without regard to food. Encourage fluids. |
Single Strength (SS) Tabs: 80 mg/400 mg
Double Strength (DS) Tabs: 160 mg/800 mg
Susp: 40 mg/200 mg/5 mL |
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 Tab PO Q12H for 3 days.
|
Important side effects: Photosensitivity, rash.
Reduce dose in renal disease (CrCl <30 mL/min). |