Antibiotics dosing

Although tetracycline, doxycycline, and minocycline are the most commonly prescribed oral antibiotics for acne, erythromycin and clindamycin are appropriate second-line agents for use when patients cannot tolerate or have developed resistance to tetracycline or its derivatives.3 See Table 62-3 for antibiotic dosing guidelines. 

Dexamethasone should be administered prior to the first antibiotic dose and not after antibiotics have already been started. Semm hemoglobin and stool guaiac should be monitored for evidence of GI bleeding. 

TABLE 43-8 1 Antibiotic Doses for the Treatment of Bacterial Pneumonia ... 

Erythromycin, Ophthalmic (llotycin Ophthalmic) [Anti infective, Macrolioe, Opthalmic agent] U e Conjunctival/comeal Infxns Action Macrolide antibiotic Dose 1/2 in 2-6 x /d Caution [B, +] Contra Erythromycin hyp sensitivity Disp Oint SE Local irritation EMS See Erythromycin may cause burning, stinging, blurred vision... 

Helicobacter pylori duodenal ulcer PO 20 mg once daily or 40 mg/day as a single or in 2 divided doses in combination therapy with antibiotics. Dose varies with regimen used. 

Gh[88] (VA) To evaluate impact of concurrent antibiotic use program OA Pre/post None Length of antibiotic therapy, mortality, DCA, pharmacy cost, nursing cost Decreased number of antibiotic doses/patient by 24% 32% reduction in drug costs Input costs not considered... 

Avorn, J. Soumerai, S.B. Reduction of incorrect antibiotic dosing through a structured educational order form. Arch. Intern. Med. 1988, 148, 1720-1724. 

Most infectious diseases pharmacists who practice in a hospital setting round with an infectious diseases consult service. This service usually consists of an infectious diseases physician, an infectious diseases medical fellow, medical students, an infectious diseases pharmacist, and (possibly) pharmacy students, residents, or fellows. Patients are usually identified through infectious diseases consults. The pharmacist usually acts to optimize the antimicrobial regimen by adjusting antibiotic doses... 

Antibiotic Dose (mg/kg/d) Regimen Adult Maximum Dose (s/d)... 

TABLE 45—9. Intraperitoneal Antibiotic Dosing Recommendations for CARD Patients ... 

Estimated renal function should be calculated for every pa- tient who is to receive antibiotics and the antibiotic dose interval adjusted accordingly. Hepatic function should be considered for drugs eliminated through the hepatobiliary system, such as clindamycin, erythromycin, and metronidazole. 

Despite the importance of appropriately timed prophylactic antibiotic therapy, few patients receive antibiotics at the optimal time in relation to surgery. Potential barriers include antibiotics ordered after the patient has arrived in the operating room, delayed antibiotic preparation or delivery, and the use of antibiotics that require long infusion times. One study assessed the timing of prophylactic antibiotics in 100 patients and found that only 26% of patients received an antibiotic dose within 2 hours of the initial surgical incision. ... 

Martin DF, Ficker LA, Aguilar HA, Gardner SK, Wilson LA, Meredith TA. Vitreous cefazolin levels after intravenous injection effects of inflammation, repeated antibiotic doses, and surgery. Arch Ophthalmol 1990 108 411-414. 

Antibiotics should be administered 30-60 minutes prior to incision and may need to be re administered to maintain effective serum drug concentrations during prolonged procedures. A single preoperative antibiotic dose is usually sufficient prophylaxis. Continuation of antibiotics for up to 24 hours may be considered in some cases (e.g., contaminated cases, surgery of long duration, implantation of prosthetic material). 

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