Adox Pak 2 / 100

Name: Adox Pak 2 / 100

What are some other side effects of Adox Pak 2/100?

All drugs may cause side effects. However, many people have no side effects or only have minor side effects. Call your doctor or get medical help if any of these side effects or any other side effects bother you or do not go away:

  • Not hungry.
  • Upset stomach or throwing up.
  • Loose stools (diarrhea).

These are not all of the side effects that may occur. If you have questions about side effects, call your doctor. Call your doctor for medical advice about side effects.

You may report side effects to the FDA at 1-800-FDA-1088. You may also report side effects at http://www.fda.gov/medwatch.

What happens if I overdose?

Seek emergency medical attention or call the Poison Help line at 1-800-222-1222.

Usual Adult Dose for Acne

IV:
-Initial dose: 200 mg IV on the first day, given in 1 or 2 infusions
-Maintenance dose: 100 to 200 mg/day IV

ORAL:
Most Products:
-Initial dose: 200 mg orally on the first day, given in 2 divided doses (100 mg every 12 hours)
-Maintenance dose: 100 mg orally once a day OR 50 mg orally every 12 hours
---More severe infections (especially chronic urinary tract infections): 100 mg orally every 12 hours

Doryx(R) MPC:
-Initial dose: 240 mg orally on the first day, given in 2 divided doses (120 mg every 12 hours)
-Maintenance dose: 120 mg orally once a day or 60 mg orally every 12 hours
---More severe infections (especially chronic urinary tract infections): 120 mg orally every 12 hours

Comments:
-The IV maintenance dose depends on the severity of the infection; the 200 mg dose may be given in 1 or 2 infusions.
-If using a monohydrate formulation, the initial oral dose may be given in 2 or 4 divided doses (100 mg every 12 hours or 50 mg every 6 hours).
-With trachoma, infectious agent is not always eliminated (as assessed by immunofluorescence).
-When used in streptococcal infections, duration of therapy should be 10 days.

Uses:
-For the treatment of the following infections: Psittacosis (ornithosis) due to Chlamydophila psittaci; chancroid due to Haemophilus ducreyi; relapsing fever due to Borrelia recurrentis; Campylobacter fetus infections; bartonellosis due to Bartonella bacilliformis; trachoma or inclusion conjunctivitis due to Chlamydia trachomatis; respiratory tract infections due to Mycoplasma pneumoniae
-For the treatment of infections due to the following bacteria when bacteriological testing shows suitable susceptibility to this drug: Escherichia coli; Enterobacter aerogenes; Shigella species; Acinetobacter species; respiratory tract infections due to H influenzae or Klebsiella species; upper respiratory infections due to Streptococcus pneumoniae; urinary tract infections due to Klebsiella species
-When penicillin is contraindicated, as an alternative agent for the treatment of the following infections: Yaws due to Treponema pallidum subspecies pertenue; listeriosis due to Listeria monocytogenes; Vincent's infection due to Fusobacterium fusiforme; actinomycosis due to Actinomyces israelii; infections due to Clostridium species
-As adjunctive therapy for: Acute intestinal amebiasis; severe acne

Usual Adult Dose for Mycoplasma Pneumonia

IV:
-Initial dose: 200 mg IV on the first day, given in 1 or 2 infusions
-Maintenance dose: 100 to 200 mg/day IV

ORAL:
Most Products:
-Initial dose: 200 mg orally on the first day, given in 2 divided doses (100 mg every 12 hours)
-Maintenance dose: 100 mg orally once a day OR 50 mg orally every 12 hours
---More severe infections (especially chronic urinary tract infections): 100 mg orally every 12 hours

Doryx(R) MPC:
-Initial dose: 240 mg orally on the first day, given in 2 divided doses (120 mg every 12 hours)
-Maintenance dose: 120 mg orally once a day or 60 mg orally every 12 hours
---More severe infections (especially chronic urinary tract infections): 120 mg orally every 12 hours

Comments:
-The IV maintenance dose depends on the severity of the infection; the 200 mg dose may be given in 1 or 2 infusions.
-If using a monohydrate formulation, the initial oral dose may be given in 2 or 4 divided doses (100 mg every 12 hours or 50 mg every 6 hours).
-With trachoma, infectious agent is not always eliminated (as assessed by immunofluorescence).
-When used in streptococcal infections, duration of therapy should be 10 days.

Uses:
-For the treatment of the following infections: Psittacosis (ornithosis) due to Chlamydophila psittaci; chancroid due to Haemophilus ducreyi; relapsing fever due to Borrelia recurrentis; Campylobacter fetus infections; bartonellosis due to Bartonella bacilliformis; trachoma or inclusion conjunctivitis due to Chlamydia trachomatis; respiratory tract infections due to Mycoplasma pneumoniae
-For the treatment of infections due to the following bacteria when bacteriological testing shows suitable susceptibility to this drug: Escherichia coli; Enterobacter aerogenes; Shigella species; Acinetobacter species; respiratory tract infections due to H influenzae or Klebsiella species; upper respiratory infections due to Streptococcus pneumoniae; urinary tract infections due to Klebsiella species
-When penicillin is contraindicated, as an alternative agent for the treatment of the following infections: Yaws due to Treponema pallidum subspecies pertenue; listeriosis due to Listeria monocytogenes; Vincent's infection due to Fusobacterium fusiforme; actinomycosis due to Actinomyces israelii; infections due to Clostridium species
-As adjunctive therapy for: Acute intestinal amebiasis; severe acne

Usual Adult Dose for Pneumonia

IV:
-Initial dose: 200 mg IV on the first day, given in 1 or 2 infusions
-Maintenance dose: 100 to 200 mg/day IV

ORAL:
Most Products:
-Initial dose: 200 mg orally on the first day, given in 2 divided doses (100 mg every 12 hours)
-Maintenance dose: 100 mg orally once a day OR 50 mg orally every 12 hours
---More severe infections (especially chronic urinary tract infections): 100 mg orally every 12 hours

Doryx(R) MPC:
-Initial dose: 240 mg orally on the first day, given in 2 divided doses (120 mg every 12 hours)
-Maintenance dose: 120 mg orally once a day or 60 mg orally every 12 hours
---More severe infections (especially chronic urinary tract infections): 120 mg orally every 12 hours

Comments:
-The IV maintenance dose depends on the severity of the infection; the 200 mg dose may be given in 1 or 2 infusions.
-If using a monohydrate formulation, the initial oral dose may be given in 2 or 4 divided doses (100 mg every 12 hours or 50 mg every 6 hours).
-With trachoma, infectious agent is not always eliminated (as assessed by immunofluorescence).
-When used in streptococcal infections, duration of therapy should be 10 days.

Uses:
-For the treatment of the following infections: Psittacosis (ornithosis) due to Chlamydophila psittaci; chancroid due to Haemophilus ducreyi; relapsing fever due to Borrelia recurrentis; Campylobacter fetus infections; bartonellosis due to Bartonella bacilliformis; trachoma or inclusion conjunctivitis due to Chlamydia trachomatis; respiratory tract infections due to Mycoplasma pneumoniae
-For the treatment of infections due to the following bacteria when bacteriological testing shows suitable susceptibility to this drug: Escherichia coli; Enterobacter aerogenes; Shigella species; Acinetobacter species; respiratory tract infections due to H influenzae or Klebsiella species; upper respiratory infections due to Streptococcus pneumoniae; urinary tract infections due to Klebsiella species
-When penicillin is contraindicated, as an alternative agent for the treatment of the following infections: Yaws due to Treponema pallidum subspecies pertenue; listeriosis due to Listeria monocytogenes; Vincent's infection due to Fusobacterium fusiforme; actinomycosis due to Actinomyces israelii; infections due to Clostridium species
-As adjunctive therapy for: Acute intestinal amebiasis; severe acne

Usual Adult Dose for Trachoma

IV:
-Initial dose: 200 mg IV on the first day, given in 1 or 2 infusions
-Maintenance dose: 100 to 200 mg/day IV

ORAL:
Most Products:
-Initial dose: 200 mg orally on the first day, given in 2 divided doses (100 mg every 12 hours)
-Maintenance dose: 100 mg orally once a day OR 50 mg orally every 12 hours
---More severe infections (especially chronic urinary tract infections): 100 mg orally every 12 hours

Doryx(R) MPC:
-Initial dose: 240 mg orally on the first day, given in 2 divided doses (120 mg every 12 hours)
-Maintenance dose: 120 mg orally once a day or 60 mg orally every 12 hours
---More severe infections (especially chronic urinary tract infections): 120 mg orally every 12 hours

Comments:
-The IV maintenance dose depends on the severity of the infection; the 200 mg dose may be given in 1 or 2 infusions.
-If using a monohydrate formulation, the initial oral dose may be given in 2 or 4 divided doses (100 mg every 12 hours or 50 mg every 6 hours).
-With trachoma, infectious agent is not always eliminated (as assessed by immunofluorescence).
-When used in streptococcal infections, duration of therapy should be 10 days.

Uses:
-For the treatment of the following infections: Psittacosis (ornithosis) due to Chlamydophila psittaci; chancroid due to Haemophilus ducreyi; relapsing fever due to Borrelia recurrentis; Campylobacter fetus infections; bartonellosis due to Bartonella bacilliformis; trachoma or inclusion conjunctivitis due to Chlamydia trachomatis; respiratory tract infections due to Mycoplasma pneumoniae
-For the treatment of infections due to the following bacteria when bacteriological testing shows suitable susceptibility to this drug: Escherichia coli; Enterobacter aerogenes; Shigella species; Acinetobacter species; respiratory tract infections due to H influenzae or Klebsiella species; upper respiratory infections due to Streptococcus pneumoniae; urinary tract infections due to Klebsiella species
-When penicillin is contraindicated, as an alternative agent for the treatment of the following infections: Yaws due to Treponema pallidum subspecies pertenue; listeriosis due to Listeria monocytogenes; Vincent's infection due to Fusobacterium fusiforme; actinomycosis due to Actinomyces israelii; infections due to Clostridium species
-As adjunctive therapy for: Acute intestinal amebiasis; severe acne

Usual Adult Dose for Acne Rosacea

40 mg orally once a day in the morning

Comments:
-The 40 mg capsule formulation
-This product should be taken on an empty stomach, preferably at least 1 hour prior to or 2 hours after meals.
-No meaningful effect shown for generalized erythema of rosacea.
-Safety and efficacy have not been established beyond 9 months and 16 weeks, respectively.
-This product has not been evaluated for treatment of erythematous, telangiectatic, or ocular components of rosacea.

Use: For the treatment of only inflammatory lesions (papules and pustules) of rosacea

Usual Adult Dose for Inhalation Bacillus anthracis

Most products: 100 mg orally or IV twice a day
-Alternatively, Doryx(R) MPC: 120 mg orally twice a day
Duration of therapy: 60 days

Comments:
-Parenteral therapy is recommended only when oral therapy is not indicated and should not be continued over an extended period.
-Oral therapy should be started as soon as possible.
-Treatment duration of 60 days includes any parenteral therapy plus oral therapy.

Use: For the treatment of anthrax due to Bacillus anthracis (including inhalational anthrax [postexposure]) to reduce the incidence or progression of disease after exposure to aerosolized B anthracis

US CDC Recommendations:
-IV: 200 mg IV initially then 100 mg IV every 12 hours
-Oral: 100 mg orally every 12 hours

Duration of Therapy:
Postexposure prophylaxis for B anthracis infection: 60 days

Systemic anthrax:
-When meningitis has been excluded: At least 2 weeks or until patient is clinically stable (whichever is longer)
-Patients exposed to aerosolized spores will require prophylaxis to complete an antimicrobial regimen of 60 days from onset of illness.

Cutaneous anthrax without systemic involvement:
-Bioterrorism-related cases: 60 days
-Naturally-acquired cases: 7 to 10 days

Comments:
-Recommended as a preferred oral drug for postexposure prophylaxis and for the treatment of cutaneous anthrax without systemic involvement
-Recommended as an alternative IV protein synthesis inhibitor for systemic anthrax when meningitis has been excluded
-Recommended for all strains (regardless of penicillin susceptibility or if susceptibility unknown) when used for postexposure prophylaxis or cutaneous anthrax without systemic involvement
-Systemic anthrax includes anthrax meningitis, inhalation anthrax, injection anthrax, gastrointestinal anthrax, and cutaneous anthrax with systemic involvement, extensive edema, or lesions of the head or neck.
-Current guidelines should be consulted for additional information.

Usual Adult Dose for Cutaneous Bacillus anthracis

Most products: 100 mg orally or IV twice a day
-Alternatively, Doryx(R) MPC: 120 mg orally twice a day
Duration of therapy: 60 days

Comments:
-Parenteral therapy is recommended only when oral therapy is not indicated and should not be continued over an extended period.
-Oral therapy should be started as soon as possible.
-Treatment duration of 60 days includes any parenteral therapy plus oral therapy.

Use: For the treatment of anthrax due to Bacillus anthracis (including inhalational anthrax [postexposure]) to reduce the incidence or progression of disease after exposure to aerosolized B anthracis

US CDC Recommendations:
-IV: 200 mg IV initially then 100 mg IV every 12 hours
-Oral: 100 mg orally every 12 hours

Duration of Therapy:
Postexposure prophylaxis for B anthracis infection: 60 days

Systemic anthrax:
-When meningitis has been excluded: At least 2 weeks or until patient is clinically stable (whichever is longer)
-Patients exposed to aerosolized spores will require prophylaxis to complete an antimicrobial regimen of 60 days from onset of illness.

Cutaneous anthrax without systemic involvement:
-Bioterrorism-related cases: 60 days
-Naturally-acquired cases: 7 to 10 days

Comments:
-Recommended as a preferred oral drug for postexposure prophylaxis and for the treatment of cutaneous anthrax without systemic involvement
-Recommended as an alternative IV protein synthesis inhibitor for systemic anthrax when meningitis has been excluded
-Recommended for all strains (regardless of penicillin susceptibility or if susceptibility unknown) when used for postexposure prophylaxis or cutaneous anthrax without systemic involvement
-Systemic anthrax includes anthrax meningitis, inhalation anthrax, injection anthrax, gastrointestinal anthrax, and cutaneous anthrax with systemic involvement, extensive edema, or lesions of the head or neck.
-Current guidelines should be consulted for additional information.

Usual Adult Dose for Brucellosis

IV:
-Initial dose: 200 mg IV on the first day, given in 1 or 2 infusions
-Maintenance dose: 100 to 200 mg/day IV

ORAL:
Most Products:
-Initial dose: 200 mg orally on the first day, given in 2 divided doses (100 mg every 12 hours)
-Maintenance dose: 100 mg orally once a day OR 50 mg orally every 12 hours
---More severe infections: 100 mg orally every 12 hours

Doryx(R) MPC:
-Initial dose: 240 mg orally on the first day, given in 2 divided doses (120 mg every 12 hours)
-Maintenance dose: 120 mg orally once a day or 60 mg orally every 12 hours
---More severe infections: 120 mg orally every 12 hours

Comments:
-The IV maintenance dose depends on the severity of the infection; the 200 mg dose may be given in 1 or 2 infusions.
-If using a monohydrate formulation, the initial oral dose may be given in 2 or 4 divided doses (100 mg every 12 hours or 50 mg every 6 hours).
-Coadministration with streptomycin is recommended.
-According to some experts, this drug should be used with rifampin for at least 6 to 8 weeks; current guidelines should be consulted for additional information.

Use: For the treatment of brucellosis due to Brucella species

Usual Adult Dose for Malaria

US CDC Recommendations:
-Uncomplicated malaria: 100 mg orally twice a day for 7 days
-Severe malaria: 100 mg orally or IV twice a day for 7 days

Comments:
-With quinine, recommended for uncomplicated malaria due to chloroquine-resistant P falciparum
-With quinine and primaquine, recommended for uncomplicated malaria due to chloroquine-resistant P vivax
-With quinine, recommended for severe malaria
-Current guidelines should be consulted for additional information.

Usual Adult Dose for Q Fever

IV:
-Initial dose: 200 mg IV on the first day, given in 1 or 2 infusions
-Maintenance dose: 100 to 200 mg/day IV

ORAL:
Most Products:
-Initial dose: 200 mg orally on the first day, given in 2 divided doses (100 mg every 12 hours)
-Maintenance dose: 100 mg orally once a day OR 50 mg orally every 12 hours
---More severe infections: 100 mg orally every 12 hours

Doryx(R) MPC:
-Initial dose: 240 mg orally on the first day, given in 2 divided doses (120 mg every 12 hours)
-Maintenance dose: 120 mg orally once a day or 60 mg orally every 12 hours
---More severe infections: 120 mg orally every 12 hours

Comments:
-The IV maintenance dose depends on the severity of the infection; the 200 mg dose may be given in 1 or 2 infusions.
-If using a monohydrate formulation, the initial oral dose may be given in 2 or 4 divided doses (100 mg every 12 hours or 50 mg every 6 hours).

Uses: For the treatment of rickettsial infections including Rocky Mountain spotted fever (RMSF), typhus fever and the typhus group, Q fever, rickettsialpox, and tick fevers due to Rickettsia species

US CDC Recommendations: 100 mg orally or IV twice a day

Duration of Therapy:
-RMSF, ehrlichiosis: At least 3 days after fever subsides and until evidence of clinical improvement
-Anaplasmosis: 10 days

Comments:
-Recommended as drug of choice for all tickborne rickettsial diseases
-Tickborne rickettsial diseases include RMSF due to Rickettsia rickettsii, other spotted fever group rickettsioses due to R parkeri and Rickettsia species 364D, Ehrlichia chaffeensis ehrlichiosis (i.e., human monocytic ehrlichiosis), other ehrlichioses due to E ewingii and E muris-like agent, and anaplasmosis due to Anaplasma phagocytophilum (i.e., human granulocytic anaplasmosis).
-The usual minimum duration of therapy for RMSF and ehrlichiosis is 5 to 7 days (total); severe/complicated disease may require longer therapy.
-According to some experts, typical duration of therapy for ehrlichiosis is 7 to 14 days.
-Current guidelines should be consulted for additional information.

Usual Adult Dose for Lyme Disease - Carditis

IDSA Recommendations: 100 mg orally twice a day

Duration of Therapy:
-Acrodermatitis chronica atrophicans: 21 days
-Cardiac disease: 14 to 21 days
-Erythema migrans: 10 to 21 days
-Lyme arthritis: 28 days

Comments:
-Recommended for the treatment of early localized or early disseminated Lyme disease associated with erythema migrans when specific neurologic manifestations or advanced atrioventricular heart block absent, uncomplicated Lyme arthritis in patients without clinical evidence of neurologic disease, patients with atrioventricular heart block and/or myopericarditis associated with early Lyme disease, and acrodermatitis chronica atrophicans
-A parenteral antibiotic (e.g., ceftriaxone) is recommended as initial treatment of patients hospitalized for cardiac monitoring; an oral regimen may be used for completion of therapy and for ambulatory patients.
-Current guidelines should be consulted for additional information.

Usual Adult Dose for Wound Infection

US CDC Recommendations: 100 mg orally or IV twice a day for 7 to 14 days

Comments:
-In combination with a third-generation cephalosporin (e.g., ceftazidime), recommended for the treatment of V vulnificus wound infections
-Current guidelines should be consulted for additional information.

Usual Pediatric Dose for Amebiasis

IV:
Less than 45 kg:
All patients with severe or life-threatening infections (e.g., RMSF): 2.2 mg/kg IV every 12 hours

Patients older than 8 years with less severe infections:
-Initial dose: 4.4 mg/kg IV on the first day, given in 2 infusions
-Maintenance dose: 2.2 mg/kg IV once a day or 1.1 mg/kg IV twice a day

At least 45 kg:
-Initial dose: 200 mg IV on the first day, given in 1 or 2 infusions
-Maintenance dose: 100 to 200 mg/day IV

ORAL:
Most Products:
Less than 45 kg:
All patients with severe or life-threatening infections: 2.2 mg/kg orally every 12 hours

Patients older than 8 years with less severe infections:
-Initial dose: 4.4 mg/kg orally on the first day, given in 2 divided doses
-Maintenance dose: 2.2 mg/kg orally once a day or 1.1 mg/kg orally twice a day

At least 45 kg:
-Initial dose: 200 mg orally on the first day, given in 2 divided doses (100 mg every 12 hours)
-Maintenance dose: 100 mg orally once a day OR 50 mg orally every 12 hours
---More severe infections: 100 mg orally every 12 hours

Doryx(R) MPC:
Less than 45 kg:
All patients with severe or life-threatening infections: 2.6 mg/kg orally every 12 hours

Patients older than 8 years with less severe infections:
-Initial dose: 5.3 mg/kg orally on the first day, given in 2 divided doses
-Maintenance dose: 2.6 mg/kg orally once a day or 1.3 mg/kg orally twice a day

At least 45 kg:
-Initial dose: 240 mg orally on the first day, given in 2 divided doses (120 mg every 12 hours)
-Maintenance dose: 120 mg orally once a day or 60 mg orally every 12 hours
---More severe infections: 120 mg orally every 12 hours

Comments:
-The IV maintenance dose for patients weighing at least 45 kg depends on the severity of the infection; the 200 mg dose may be given in 1 or 2 infusions.
-For patients at least 45 kg using a monohydrate formulation, the initial oral dose may be given in 2 or 4 divided doses (100 mg every 12 hours or 50 mg every 6 hours).
-With trachoma, the infectious agent is not always eliminated (as assessed by immunofluorescence).
-Coadministration with streptomycin recommended for brucellosis.

Uses:
-For the treatment of the following infection: Psittacosis (ornithosis) due to C psittaci; chancroid due to H ducreyi; relapsing fever due to B recurrentis; C fetus infections; brucellosis due to Brucella species; bartonellosis due to B bacilliformis; trachoma or inclusion conjunctivitis due to C trachomatis
-For the treatment of infections due to the following bacteria when bacteriological testing shows suitable susceptibility to this drug: E coli; E aerogenes; Shigella species; Acinetobacter species; urinary tract infections due to Klebsiella species
-When penicillin is contraindicated, as an alternative agent for the treatment of the following infections: Yaws due to T pallidum subspecies pertenue; listeriosis due to L monocytogenes; Vincent's infection due to F fusiforme; actinomycosis due to A israelii; infections due to Clostridium species
-As adjunctive therapy for: Acute intestinal amebiasis; severe acne

American Academy of Pediatrics (AAP) Recommendations:
1 month or older:
-Mild to moderate infections: 2 to 4 mg/kg/day orally or IV in 1 to 2 divided doses
-Severe infections: 2 mg/kg orally or IV every 12 hours
Maximum dose: 200 mg/day

Comments:
-Risk of dental staining in children younger than 8 years is unlikely at the dose and duration recommended to treat serious infections.
-Current guidelines should be consulted for additional information.

Usual Pediatric Dose for Brucellosis

IV:
Less than 45 kg:
All patients with severe or life-threatening infections (e.g., RMSF): 2.2 mg/kg IV every 12 hours

Patients older than 8 years with less severe infections:
-Initial dose: 4.4 mg/kg IV on the first day, given in 2 infusions
-Maintenance dose: 2.2 mg/kg IV once a day or 1.1 mg/kg IV twice a day

At least 45 kg:
-Initial dose: 200 mg IV on the first day, given in 1 or 2 infusions
-Maintenance dose: 100 to 200 mg/day IV

ORAL:
Most Products:
Less than 45 kg:
All patients with severe or life-threatening infections: 2.2 mg/kg orally every 12 hours

Patients older than 8 years with less severe infections:
-Initial dose: 4.4 mg/kg orally on the first day, given in 2 divided doses
-Maintenance dose: 2.2 mg/kg orally once a day or 1.1 mg/kg orally twice a day

At least 45 kg:
-Initial dose: 200 mg orally on the first day, given in 2 divided doses (100 mg every 12 hours)
-Maintenance dose: 100 mg orally once a day OR 50 mg orally every 12 hours
---More severe infections: 100 mg orally every 12 hours

Doryx(R) MPC:
Less than 45 kg:
All patients with severe or life-threatening infections: 2.6 mg/kg orally every 12 hours

Patients older than 8 years with less severe infections:
-Initial dose: 5.3 mg/kg orally on the first day, given in 2 divided doses
-Maintenance dose: 2.6 mg/kg orally once a day or 1.3 mg/kg orally twice a day

At least 45 kg:
-Initial dose: 240 mg orally on the first day, given in 2 divided doses (120 mg every 12 hours)
-Maintenance dose: 120 mg orally once a day or 60 mg orally every 12 hours
---More severe infections: 120 mg orally every 12 hours

Comments:
-The IV maintenance dose for patients weighing at least 45 kg depends on the severity of the infection; the 200 mg dose may be given in 1 or 2 infusions.
-For patients at least 45 kg using a monohydrate formulation, the initial oral dose may be given in 2 or 4 divided doses (100 mg every 12 hours or 50 mg every 6 hours).
-With trachoma, the infectious agent is not always eliminated (as assessed by immunofluorescence).
-Coadministration with streptomycin recommended for brucellosis.

Uses:
-For the treatment of the following infection: Psittacosis (ornithosis) due to C psittaci; chancroid due to H ducreyi; relapsing fever due to B recurrentis; C fetus infections; brucellosis due to Brucella species; bartonellosis due to B bacilliformis; trachoma or inclusion conjunctivitis due to C trachomatis
-For the treatment of infections due to the following bacteria when bacteriological testing shows suitable susceptibility to this drug: E coli; E aerogenes; Shigella species; Acinetobacter species; urinary tract infections due to Klebsiella species
-When penicillin is contraindicated, as an alternative agent for the treatment of the following infections: Yaws due to T pallidum subspecies pertenue; listeriosis due to L monocytogenes; Vincent's infection due to F fusiforme; actinomycosis due to A israelii; infections due to Clostridium species
-As adjunctive therapy for: Acute intestinal amebiasis; severe acne

American Academy of Pediatrics (AAP) Recommendations:
1 month or older:
-Mild to moderate infections: 2 to 4 mg/kg/day orally or IV in 1 to 2 divided doses
-Severe infections: 2 mg/kg orally or IV every 12 hours
Maximum dose: 200 mg/day

Comments:
-Risk of dental staining in children younger than 8 years is unlikely at the dose and duration recommended to treat serious infections.
-Current guidelines should be consulted for additional information.

Usual Pediatric Dose for Urinary Tract Infection

IV:
Less than 45 kg:
All patients with severe or life-threatening infections (e.g., RMSF): 2.2 mg/kg IV every 12 hours

Patients older than 8 years with less severe infections:
-Initial dose: 4.4 mg/kg IV on the first day, given in 2 infusions
-Maintenance dose: 2.2 mg/kg IV once a day or 1.1 mg/kg IV twice a day

At least 45 kg:
-Initial dose: 200 mg IV on the first day, given in 1 or 2 infusions
-Maintenance dose: 100 to 200 mg/day IV

ORAL:
Most Products:
Less than 45 kg:
All patients with severe or life-threatening infections: 2.2 mg/kg orally every 12 hours

Patients older than 8 years with less severe infections:
-Initial dose: 4.4 mg/kg orally on the first day, given in 2 divided doses
-Maintenance dose: 2.2 mg/kg orally once a day or 1.1 mg/kg orally twice a day

At least 45 kg:
-Initial dose: 200 mg orally on the first day, given in 2 divided doses (100 mg every 12 hours)
-Maintenance dose: 100 mg orally once a day OR 50 mg orally every 12 hours
---More severe infections: 100 mg orally every 12 hours

Doryx(R) MPC:
Less than 45 kg:
All patients with severe or life-threatening infections: 2.6 mg/kg orally every 12 hours

Patients older than 8 years with less severe infections:
-Initial dose: 5.3 mg/kg orally on the first day, given in 2 divided doses
-Maintenance dose: 2.6 mg/kg orally once a day or 1.3 mg/kg orally twice a day

At least 45 kg:
-Initial dose: 240 mg orally on the first day, given in 2 divided doses (120 mg every 12 hours)
-Maintenance dose: 120 mg orally once a day or 60 mg orally every 12 hours
---More severe infections: 120 mg orally every 12 hours

Comments:
-The IV maintenance dose for patients weighing at least 45 kg depends on the severity of the infection; the 200 mg dose may be given in 1 or 2 infusions.
-For patients at least 45 kg using a monohydrate formulation, the initial oral dose may be given in 2 or 4 divided doses (100 mg every 12 hours or 50 mg every 6 hours).
-With trachoma, the infectious agent is not always eliminated (as assessed by immunofluorescence).
-Coadministration with streptomycin recommended for brucellosis.

Uses:
-For the treatment of the following infection: Psittacosis (ornithosis) due to C psittaci; chancroid due to H ducreyi; relapsing fever due to B recurrentis; C fetus infections; brucellosis due to Brucella species; bartonellosis due to B bacilliformis; trachoma or inclusion conjunctivitis due to C trachomatis
-For the treatment of infections due to the following bacteria when bacteriological testing shows suitable susceptibility to this drug: E coli; E aerogenes; Shigella species; Acinetobacter species; urinary tract infections due to Klebsiella species
-When penicillin is contraindicated, as an alternative agent for the treatment of the following infections: Yaws due to T pallidum subspecies pertenue; listeriosis due to L monocytogenes; Vincent's infection due to F fusiforme; actinomycosis due to A israelii; infections due to Clostridium species
-As adjunctive therapy for: Acute intestinal amebiasis; severe acne

American Academy of Pediatrics (AAP) Recommendations:
1 month or older:
-Mild to moderate infections: 2 to 4 mg/kg/day orally or IV in 1 to 2 divided doses
-Severe infections: 2 mg/kg orally or IV every 12 hours
Maximum dose: 200 mg/day

Comments:
-Risk of dental staining in children younger than 8 years is unlikely at the dose and duration recommended to treat serious infections.
-Current guidelines should be consulted for additional information.

Usual Pediatric Dose for Cutaneous Bacillus anthracis

Less than 45 kg:
-Most products: 2.2 mg/kg orally or IV twice a day
---Alternatively, Doryx(R) MPC: 2.6 mg/kg orally twice a day

At least 45 kg:
-Most products: 100 mg orally or IV twice a day
---Alternatively, Doryx(R) MPC: 120 mg orally twice a day

Duration of therapy: 60 days

Comments:
-Parenteral therapy is recommended only when oral therapy is not indicated and should not be continued over an extended period.
-Oral therapy should be started as soon as possible.
-Treatment duration of 60 days includes any parenteral therapy plus oral therapy.

Use: For the treatment of anthrax due to B anthracis (including inhalational anthrax [postexposure]) to reduce the incidence or progression of disease after exposure to aerosolized B anthracis

AAP Recommendations:
Term neonate (younger than 1 month): 4.4 mg/kg orally or IV initially then 2.2 mg/kg orally or IV every 12 hours

Children 1 month or older:
IV:
-Less than 45 kg: 4.4 mg/kg IV initially then 2.2 mg/kg IV every 12 hours
-At least 45 kg: 200 mg IV initially then 100 mg IV every 12 hours

ORAL:
-Less than 45 kg: 2.2 mg/kg orally every 12 hours
-At least 45 kg: 100 mg orally every 12 hours

Duration of Therapy:
Postexposure prophylaxis for B anthracis infection: 60 days after exposure

Systemic/severe anthrax when meningitis has been excluded:
-Term neonate (younger than 1 month): At least 2 to 3 weeks or until patient is clinically stable (whichever is longer)
-Children 1 month or older: At least 14 days or until patient is clinically stable (whichever is longer)
-Patients will require prophylaxis to complete an antimicrobial regimen of up to 60 days from onset of illness.

Cutaneous anthrax without systemic involvement:
-Bioterrorism-related cases: To complete an antimicrobial regimen of up to 60 days from onset of illness
-Naturally-acquired cases: 7 to 10 days

Follow-up for severe anthrax:
-Term neonate (younger than 1 month): To complete a regimen of at least 10 to 14 days
-Children 1 month or older: To complete a regimen of at least 14 days
-Patients may require prophylaxis to complete an antimicrobial regimen of up to 60 days from onset of illness.

Comments:
-Recommended for postexposure prophylaxis as a preferred oral drug in children 1 month or older and as an alternative oral drug for term neonates (younger than 1 month)
-Recommended as an alternative oral drug for the treatment of cutaneous anthrax without systemic involvement
-Recommended as an alternative protein synthesis inhibitor for the IV treatment of systemic/severe anthrax when meningitis has been excluded and for oral follow-up for severe anthrax
-Recommended for all strains (regardless of penicillin susceptibility or if susceptibility unknown) when used for postexposure prophylaxis or cutaneous anthrax without systemic involvement
-Systemic/severe anthrax includes anthrax meningitis, inhalation anthrax, injection anthrax, gastrointestinal anthrax, and cutaneous anthrax with systemic involvement, extensive edema, or lesions of the head or neck.
-Current guidelines should be consulted for additional information.

Usual Pediatric Dose for Q Fever

IV:
Less than 45 kg:
All patients with severe or life-threatening infections (e.g., RMSF): 2.2 mg/kg IV every 12 hours

Patients older than 8 years with less severe infections:
-Initial dose: 4.4 mg/kg IV on the first day, given in 2 infusions
-Maintenance dose: 2.2 mg/kg IV once a day or 1.1 mg/kg IV twice a day

At least 45 kg:
-Initial dose: 200 mg IV on the first day, given in 1 or 2 infusions
-Maintenance dose: 100 to 200 mg/day IV

ORAL:
Most Products:
Less than 45 kg:
All patients with severe or life-threatening infections: 2.2 mg/kg orally every 12 hours

Patients older than 8 years with less severe infections:
-Initial dose: 4.4 mg/kg orally on the first day, given in 2 divided doses
-Maintenance dose: 2.2 mg/kg orally once a day or 1.1 mg/kg orally twice a day

At least 45 kg:
-Initial dose: 200 mg orally on the first day, given in 2 divided doses (100 mg every 12 hours)
-Maintenance dose: 100 mg orally once a day OR 50 mg orally every 12 hours
---More severe infections: 100 mg orally every 12 hours

Doryx(R) MPC:
Less than 45 kg:
All patients with severe or life-threatening infections: 2.6 mg/kg orally every 12 hours

Patients older than 8 years with less severe infections:
-Initial dose: 5.3 mg/kg orally on the first day, given in 2 divided doses
-Maintenance dose: 2.6 mg/kg orally once a day or 1.3 mg/kg orally twice a day

At least 45 kg:
-Initial dose: 240 mg orally on the first day, given in 2 divided doses (120 mg every 12 hours)
-Maintenance dose: 120 mg orally once a day or 60 mg orally every 12 hours
---More severe infections: 120 mg orally every 12 hours

Comments:
-The IV maintenance dose for patients weighing at least 45 kg depends on the severity of the infection; the 200 mg dose may be given in 1 or 2 infusions.
-For patients at least 45 kg using a monohydrate formulation, the initial oral dose may be given in 2 or 4 divided doses (100 mg every 12 hours or 50 mg every 6 hours).

Uses: For the treatment of rickettsial infections including RMSF, typhus fever and the typhus group, Q fever, rickettsialpox, and tick fevers due to Rickettsia species

US CDC and AAP Recommendations:
-Less than 45 kg: 2.2 mg/kg orally or IV twice a day
-At least 45 kg: 100 mg orally or IV twice a day

Duration of Therapy:
-RMSF, ehrlichiosis: At least 3 days after fever subsides and until evidence of clinical improvement
-Anaplasmosis: 10 days

Comments:
-Recommended as drug of choice for all tickborne rickettsial diseases; recommended for patients of all ages
-Tickborne rickettsial diseases include RMSF due to R rickettsii, other spotted fever group rickettsioses due to R parkeri and Rickettsia species 364D, E chaffeensis ehrlichiosis (i.e., human monocytic ehrlichiosis), other ehrlichioses due to E ewingii and E muris-like agent, and anaplasmosis due to A phagocytophilum (i.e., human granulocytic anaplasmosis).
-The usual minimum duration of therapy for RMSF and ehrlichiosis is 5 to 7 days (total); severe/complicated disease may require longer therapy.
-According to some experts, typical duration of therapy for ehrlichiosis is 7 to 14 days.
-Current guidelines should be consulted for additional information.

Usual Pediatric Dose for Malaria Prophylaxis

8 years or older:
Most products: 2 mg/kg orally once a day
Maximum dose: 100 mg/dose

Doryx(R) MPC: 2.4 mg/kg orally once a day
-At least 45 kg: 120 mg orally once a day

Comments:
-Prophylaxis should start 1 to 2 days before travel to endemic area; should continue daily while in malarious areas and for 4 weeks after leaving such areas
-Prophylaxis with this drug should not exceed 4 months.
-According to some manufacturers, patients weighing at least 45 kg should receive the adult dose.

Use: For prophylaxis of malaria due to P falciparum in short-term travelers (less than 4 months) to areas with chloroquine and/or pyrimethamine-sulfadoxine resistant strains

US CDC Recommendations:
8 years or older: 2.2 mg/kg orally once a day
Maximum dose: 100 mg/dose

Comments:
-Recommended for prophylaxis in all areas
-Not recommended for use during pregnancy or in patients younger than 8 years.
-Current guidelines should be consulted for additional information.

Usual Pediatric Dose for Lyme Disease - Erythema Chronicum Migrans

IDSA Recommendations:
8 years or older: 2 mg/kg orally twice a day
Maximum dose: 100 mg/dose

Duration of Therapy:
-Acrodermatitis chronica atrophicans: 21 days
-Cardiac disease: 14 to 21 days
-Erythema migrans: 10 to 21 days
-Lyme arthritis: 28 days

Comments:
-Recommended for the treatment of early localized or early disseminated Lyme disease associated with erythema migrans when specific neurologic manifestations or advanced atrioventricular heart block absent, uncomplicated Lyme arthritis in patients without clinical evidence of neurologic disease, patients with atrioventricular heart block and/or myopericarditis associated with early Lyme disease, and acrodermatitis chronica atrophicans
-A parenteral antibiotic (e.g., ceftriaxone) is recommended as initial treatment of patients hospitalized for cardiac monitoring; an oral regimen may be used for completion of therapy and for ambulatory patients.
-Current guidelines should be consulted for additional information.

Usual Pediatric Dose for Pelvic Inflammatory Disease

US CDC Recommendations:
-Adolescents: 100 mg orally or IV every 12 hours
Duration of therapy: 14 days

Comments:
-With other agents, recommended as part of a parenteral regimen or as part of an IM/oral regimen; also recommended as part of an alternative parenteral regimen
-This drug may be switched from IV to oral administration 24 to 48 hours after clinical improvement to complete 14 days of therapy.
-Current guidelines should be consulted for additional information.

How it works

  • Doxycycline is an antibiotic used to treat a wide range of infections caused by susceptible gram negative, gram positive, anaerobic, and other bacteria.
  • Doxycycline is synthetically derived from oxytetracycline (oxytetracycline was first manufactured in 1950).
  • Doxycycline works by inhibiting bacterial protein synthesis by binding to a ribosomal subunit, preventing amino acids from being linked together. Without proteins, bacteria are unable to function.
  • Doxycycline is bacteriostatic (stops bacteria from reproducing, doesn't necessarily kill them).
  • Doxycycline belongs to the group of medicines known as tetracyclines.
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