Ohio Dentist and Dental Hygienist Ebook Continuing Education

Antibiotics Review _ __________________________________________________________________________

THE SULFONAMIDES

Agent

Adult Dosing Range

Pediatric Dosing Range

Route

Common Side Effects

Comments

Short- to Medium-Acting Sulfadiazine

PO

Rash, pruritus Multiple drug interactions. Contraindicated in infants <2 mos of age.

2–4 g/day in 3 to 6 divided doses

>2 mos (initial): 75–150 mg/kg/day in 4 to 6 divided doses >2 mos (maintenance): 150 mg/kg/day in 4 to 6

divided doses Max: 6 g/day

Sulfamethoxazole/ trimethoprim (TMP/SMX)

PO: 1–2 DS tablets every 12 to 24 hrs IV: 8–20 mg TMP/ kg/day in 2 to 4 divided doses

>2 mos PO: 6–20 mg TMP/kg/day in 2 divided doses IV: 6–20 mg TMP/ kg/day every 12 to 24 hours Max single dose: 160 mg TMP/dose

PO, IV

Rash, pruritus Multiple drug interactions. Weight-based dosing

recommendations based on trimethoprim content.

Limited to GI Tract Sulfasalazine

RA: Initial: 0.5–1 g every 6 to 8 hrs Maintenance: 2 g/ day in divided doses UC: Initial: 3–4 g in evenly divided doses every 8 hours Titrate to 4–6 g in 4 divided doses Cream: Apply 1.6 mm thick layer to burn area every 12 or 24 hrs Solution: Wet dressing gauze every 4 hrs or as needed

>2 yrs: 40–60 mg/kg/ day in 3 to 6 divided doses

PO

Anorexia, headache, GI upset

Contraindicated with hypersensitivity to salicylates, sulfasalazine, sulfonamides, or mesalamine.

Topical Mafenide

Use adult dosing

Cream, powder for solution

Burning at application site, rash, allergic reaction

Used for treatment of second- and third-degree burns to prevent infection. Burn area should be covered with cream/wet at all times. Apply with sterile gloved hand. Combinations with fluoro- metholone, prednisolone, and phenylephrine are available, each with differ- ing dosing, indications, and contraindications. Common for ophthalmic and topical use.

Silver sulfadiazine Apply 1.6-mm layer to burn area once or twice daily

Use adult dosing

Cream

Rash, allergic reaction

Sulfacetamide

Dosage varies with the preparation.

Use adult dosing

Prepared in complex with other topical medications as a solution or ointment

Rash, local irritation

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. DS = double strength; RA = rheumatoid arthritis; TMP = trimethoprim; UC = ulcerative colitis. Source: [6; 16] Table 7

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