Indications And Dose
Susceptible infections in patients with penicillin hypersensitivity (e.g. respiratory-tract infections (including Legionella infection), skin and oral infections, and campylobacter enteritis) ▶BY MOUTH ▶Child 1–23 months: 125 mg 4 times a day, total daily dose may alternatively be given in two divided doses, increased to 250 mg 4 times a day, dose increase may be used in severe infections ▶Child 2–7 years: 250 mg 4 times a day, total daily dose may alternatively be given in two divided doses, increased to 500 mg 4 times a day, dose increase may be used in severe infections ▶Child 8–17 years: 250–500 mg 4 times a day, total daily dose may alternatively be given in two divided doses, increased to 500–1000 mg 4 times a day, dose increase may be used in severe infections ▶Adult: 250–500 mg 4 times a day, total daily dose may alternatively be given in two divided doses, increased to 500–1000 mg 4 times a day, dose increase may be used in severe infections ▶BY INTRAVENOUS INFUSION ▶Child: 12.5 mg/kg every 6 hours (max. per dose 1 g) ▶Adult: 6.25 mg/kg every 6 hours, for mild infections Infection when oral treatment not possible, increased to 12.5 mg/kg every 6 hours, dose increase may be used in severe infections Impetigo ▶BY MOUTH ▶Child 8–17 years: 250–500 mg 4 times a day for 5–7 days ▶Adult: 250–500 mg 4 times a day for 5–7 days Cellulitis | Erysipelas ▶BY MOUTH ▶Child 8–17 years: 250–500 mg 4 times a day for 5–7 days then review ▶Adult: 500 mg 4 times a day for 5–7 days then review Prevention of recurrent cellulitis (specialist use only) | Prevention of recurrent erysipelas (specialist use only) ▶BY MOUTH ▶Adult: 250 mg twice daily Mild diabetic foot infection ▶BY MOUTH ▶Adult: 500 mg 4 times a day for 7 days then review Leg ulcer infection ▶BY MOUTH ▶Adult: 500 mg 4 times a day for 7 days Community-acquired pneumonia ▶BY MOUTH ▶Child 8–17 years: 250–500 mg 4 times a day for 5 days ▶Adult: 500 mg 4 times a day for 5 days Acute cough [if systemically very unwell or at higher risk of complications] | Acute sore throat ▶BY MOUTH ▶Child 1–23 months: 125 mg 4 times a day for 5 days, alternatively 250 mg twice daily for 5 days ▶Child 2–7 years: 250 mg 4 times a day for 5 days, alternatively 500 mg twice daily for 5 days ▶Child 8–17 years: 250–500 mg 4 times a day for 5 days, alternatively 500–1000 mg twice daily for 5 days ▶Adult: 250–500 mg 4 times a day for 5 days, alternatively 500–1000 mg twice daily for 5 days Acute otitis media ▶BY MOUTH ▶Child 1–23 months: 125 mg 4 times a day for 5–7 days, alternatively 250 mg twice daily for 5–7 days ▶Child 2–7 years: 250 mg 4 times a day for 5–7 days, alternatively 500 mg twice daily for 5–7 days ▶Child 8–17 years: 250–500 mg 4 times a day for 5–7 days, alternatively 500–1000 mg twice daily for 5–7 days Early syphilis ▶BY MOUTH ▶Adult: 500 mg 4 times a day for 14 days Uncomplicated genital chlamydia| Non-gonococcal urethritis ▶BY MOUTH ▶Adult: 500 mg twice daily for 14 days Chronic prostatitis ▶BY MOUTH ▶Adult: 250–500 mg 4 times a day, total daily dose may alternatively be given in two divided doses, increased to 4 g daily in divided doses, dose increase may be used continued → in severe infections ▶BY INTRAVENOUS INFUSION ▶Adult: 6.25 mg/kg every 6 hours, for mild infections when oral treatment is not possible, increased to 12.5 mg/kg every 6 hours, dose increase may be used in severe infections Prevention and treatment of pertussis ▶BY MOUTH ▶Child 1–23 months: 125 mg 4 times a day, total daily dose Infection may alternatively be given in two divided doses, increased to 250 mg 4 times a day, dose increase may be used in severe infections ▶Child 2–7 years: 250 mg 4 times a day, total daily dose may alternatively be given in two divided doses, increased to 500 mg 4 times a day, dose increase may be used in severe infections ▶Child 8–17 years: 250–500 mg 4 times a day, total daily dose may alternatively be given in two divided doses, increased to 500–1000 mg 4 times a day, dose increase may be used in severe infections ▶Adult: (consult local protocol) Prevention of secondary case of diphtheria in non- immune patient ▶BY MOUTH ▶Adult: 500 mg every 6 hours for 7 days, treat for further 10 days if nasopharyngeal swabs positive after first 7 days’ treatment Prevention of secondary case of invasive group A streptococcal infection in penicillin allergic patients ▶BY MOUTH ▶Adult: 250–500 mg every 6 hours for 10 days Prevention of pneumococcal infection in asplenia or in patients with sickle-cell disease (if penicillin-allergic) ▶BY MOUTH ▶Adult: 500 mg twice daily, antibiotic prophylaxis is not fully reliable. It may be discontinued in those with sickle-cell disease who have received pneumococcal immunisation and who do not have a history of severe pneumococcal infection Rosacea ▶BY MOUTH ▶Adult: 500 mg twice daily courses usually last 6–12 weeks and are repeated intermittently Acne ▶BY MOUTH ▶Adult: 500 mg twice daily Gastro-intestinal stasis ▶BY MOUTH ▶Adult: 250–500 mg 3 times a day for up to 4 weeks, to be taken before food ▶BY INTRAVENOUS INFUSION ▶Adult: 3 mg/kg 3 times a day l UNLICENSED USE g Duration of treatment for acute otitis media differs from product literature and adheres to national guidelines. h ▶In adults g Erythromycin is used for the prevention of recurrent cellulitis, h but the dose is not licensed for this indication. g Erythromycin is used for the prevention of recurrent erysipelas, h but the dose is not licensed for this indication. g Erythromycin may be used for gastro- intestinal stasis, l but it is not licensed for this indication.
Source pages 591, 592