By John G. Bartlett MD

Designed to supply easy access to criteria of deal with infectious affliction via targeting choice, right doses, expenses, and unwanted effects of antimicrobial brokers, the 2005-2006 notebook of Infectious disorder Therapy attracts commonly from suggestions made by means of the facilities for sickness regulate and Prevention, the scientific Letter on medicinal drugs and Therapeutics, and from authentic statements of revered scientific societies. Tabular fabric has been up-to-date to incorporate all newly licensed antibiotics, in addition to new ideas for management.

This variation comprises topical concerns akin to MRSA (USA three hundred strain), Avian influenza, Acinetobacter Hepatitis B virus (HBV), hepatitis C virus (HCV), and bioterrorism. It additionally comprises the hot guidance for pyogenic meningitis, diabetic foot infections, healthcare linked pneumonia, surgical prophylaxis, fungal infections, bacteruria, and administration of infections linked to overseas travel.

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2 20 250 mg q12 h — Usu al Usual 250 mg q24 h Cephalexin Renal 0. 2 5-1 g q24 48h Cephalothin Renal 0. 50. 5 g q8h Cephapirin Renal 0. 60. 52g q12 h Cephradine Renal 0. 51g q24 72h Chlorampheni col Hepatic 2. 25 -1 g q6h Usu al Usual Usu al Chloroquine Renal and metaboliz ed 48 12 0 ? 300 600 mg po qd — Usu al Usual 150 300 mg po qd Cidofovir Renal 17 65 ↑ — 5 mg/ kg q 2 wk Usu al Contraindica ted Cinoxacin Renal 1. 47 Clarithromy cin Hepatic and renal metaboli sm 4 250 500 mg q12 h — Usual Usual 250500 mg q24 h Clindamyci n Hepatic 22.

85 Pitfalls and notations with calculations follow. a. Elderly patient: Serum creatinine may be deceptively low (with danger of overdosing) because of reduced muscle mass. b. Pregnancy, ascites, and other causes of volume expansion: GFR may be increased (with danger of underdosing) in third trimester of pregnancy and patients with normal renal function who receive massive parenteral fluids. c. Obese patients: Use lean body weight. d. Renal failure: Formulas assume stable renal function; for patients with anuria or oliguria assume creatine clearance (CCr) of 5-8 mL/min.

3 mg/kg for gentamicin and tobramycin. b c Obese patients: use calculated lean body weight plus 40% of excess fat. d Patients who are oliguric or anuric: use CCr of 5-8 mL/min. 2. MAYO CLINIC GUIDELINES (Mayo Clin Proc 47:519, 1999) a. 5-15 mg/kg. 3 kg (height in inches - 60 inches). 4 (actual weight in kg - IBW). b. Maintenance dose: Cockcroft-Gault equation. 3. MONITORING: Measure peak levels at 1 hr after start of 20- to 30-min infusion. Goal with q8h dosing is 5-10 μg/mL for gentamicin and tobramycin or 20-40 μg/mL for amikacin; peak levels when using low doses of gentamicin or tobramycin for synergy vs staph, strep or enterococcus is 3 μg/mL.

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