Antibiotics Review _ __________________________________________________________________________
THE QUINOLONES
Agent
Adult Dosing Range
Pediatric Dosing Range
Route
Common Side Effects
Comments
Besifloxacin
1 drop 3 times daily (4 to 12 hrs apart) for 7 days PO: 250–750 mg every 12 hrs IV: 200–400 mg every 12 hrs PO: 450 mg every 12 hrs for 5 to 14 days IV: 300 mg every 12 hrs for 5 to 14 days Days 1 and 2: 1 drop every 2 hrs while awake Max: 8/day Days 3–7: 1 drop 2 to 4 times/day 250–750 mg/day for 5 to 14 days
Same as adult dosing Ophthal- mic drops
Headache
Contact lenses should not be worn during treatment
Ciprofloxacin
PO: 20–30 mg/kg/ day in 2 divided doses Max: 1.5 g/day IV: 20–30 mg/kg/day
PO, IV, topical, otic, oph- thalmic solution or oint- ment
GI upset, headache
Photosensitivity can occur. Antacids decrease absorption. Can prolong QT interval. Quinolones may cause tendon inflammation and rupture and may exacerbate myasthenia gravis associated muscle weakness.
in 2 divided doses Max: 800 mg/day
Delafloxacin
Not studied in pediatric patients
PO, IV GI upset,
increased serum transaminases
Gatifloxacin
>1 yr: same as adult dosing
Ophthal- mic drops
Headache, GI upset, conjunctival irritation, keratitis
Levofloxacin
N/A
PO, IV, ophthmal- mic drops, inhalation PO, IV, ophthal- mic drops PO, otic, ophthal- mic drops
GI upset, headache, phototoxicity
Moxifloxacin
400 mg/day for 5 to 14 days
N/A
GI upset, headache
Ofloxacin
200–400 mg every 12 hrs
N/A
GI upset, headache
Ozenoxacin
Apply thin layer to affected area (up to 100 cm 2 ) twice/day for 5 days
Infants >2 mos to 12 yrs: Same as adult dosing, except treated area may only be up to 2% of total body surface area (Max: 100 cm 2 ) >12 yrs: same as adult dosing
Topical
<1% experience rosacea-like face eruption,
Novel drug for treatment of impetigo caused by Staphylococcus aureus or Streptococcus pyogenes
seborrheic dermatitis
Prescribing information is given for comparison purposes only. The higher dosage ranges reflect dosages for more severe infections. Please consult the manufacturer’s package insert for the antibiotic for complete prescribing information, maximum dosages, and indications. Source: [6; 16] Table 6
Although allergic reactions are not common, they may occur and range from a rash to severe reactions, such as Stevens- Johnson syndrome. Very rare cases of severe fatal hypoglycemia have been reported with concurrent treatment with glyburide and ciprofloxacin [125]. Use quinolones with caution in patients with medical problems that predispose the patient to seizures. Quinolones should not be used in patients with CNS disorders [119].
There is also a risk of disabling peripheral neuropathy associ- ated with the use of oral or injectable fluoroquinolones [126]. The onset can be rapid, and patients should be advised to contact their healthcare provider if any signs or symptoms develop. In these cases, the fluoroquinolone should be stopped and an alternative non-fluoroquinolone drug used, unless the benefit of continued treatment outweighs the risk [119; 126].
108
EliteLearning.com/Dental
Powered by FlippingBook