Adox Pak 2 / 100

Name: Adox Pak 2 / 100

Uses of Adox Pak 2/100

  • It is used to treat pimples (acne).
  • It is used to treat or prevent bacterial infections.
  • It is used to prevent malaria.
  • It is used to treat swelling of the tissue around the teeth (periodontitis). It is used with scaling and root planing.
  • It may be given to you for other reasons. Talk with the doctor.

What is doxycycline?

Doxycycline is a tetracycline antibiotic that fights bacteria in the body.

Doxycycline is used to treat many different bacterial infections, such as acne, urinary tract infections, intestinal infections, eye infections, gonorrhea, chlamydia, periodontitis (gum disease), and others.

Doxycycline is also used to treat blemishes, bumps, and acne-like lesions caused by rosacea. It will not treat facial redness caused by rosacea.

Some forms of doxycycline are used to prevent malaria, to treat anthrax, or to treat infections caused by mites, ticks, or lice.

Doxycycline side effects

Get emergency medical help if you have any signs of an allergic reaction to doxycycline: hives; difficulty breathing; swelling of your face, lips, tongue, or throat.

Call your doctor at once if you have:

  • severe stomach pain, diarrhea that is watery or bloody;

  • throat irritation, trouble swallowing;

  • chest pain, irregular heart rhythm, feeling short of breath;

  • little or no urination;

  • low white blood cell counts - fever, swollen glands, body aches, flu symptoms, weakness, pale skin, easy bruising or bleeding;

  • increased pressure inside the skull - severe headaches, ringing in your ears, dizziness, nausea, vision problems, pain behind your eyes;

  • liver problems - loss of appetite, upper stomach pain, tiredness, dark urine, clay-colored stools, jaundice (yellowing of the skin or eyes);

  • pancreas problems - severe pain in your upper stomach spreading to your back, vomiting; or

  • severe skin reaction - fever, sore throat, swelling in your face or tongue, burning in your eyes, skin pain followed by a red or purple skin rash that spreads (especially in the face or upper body) and causes blistering and peeling.

Common doxycycline side effects may include:

  • nausea, vomiting, upset stomach;

  • mild diarrhea;

  • skin rash or itching; or

  • vaginal itching or discharge.

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

Usual Adult Dose for Chancroid

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 Bronchitis

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 Psittacosis

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 Cholera

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).

Use: For the treatment of cholera due to Vibrio cholerae

Infectious Diseases Society of America (IDSA) and Pan American Health Organization (PAHO) Recommendations: 300 mg orally once

Comments:
-Recommended for the treatment of infectious diarrhea due to V cholerae O1 or O139
-Current guidelines should be consulted for additional information.

Usual Adult Dose for Gonococcal Infection - Uncomplicated

Most products: 100 mg orally twice a day
-Alternatively, Doryx(R) MPC: 120 mg orally twice a day
Duration of therapy: 7 days

Alternate single visit dose:
-Most products: 300 mg orally initially followed in 1 hour by a second 300 mg dose
---Alternatively, Doryx(R) MPC: 360 mg orally initially followed in 1 hour by a second 360 mg dose

Comments:
-Not recommended for anorectal infections in men.

Use: For the treatment of uncomplicated gonorrhea due to N gonorrhoeae

US CDC Recommendations: 100 mg orally twice a day for 7 days

Comments:
-With ceftriaxone (or cefixime), recommended for uncomplicated infections of the cervix, urethra, or rectum as an alternative second antimicrobial in patients with azithromycin allergy
-The patient's sexual partner(s) should also be evaluated/treated.
-Current guidelines should be consulted for additional information.

Usual Adult Dose for Periodontitis

20 mg orally twice a day for up to 9 months

Comments:
-The 20 mg capsule or tablet formulation
-This product should be taken at least 1 hour prior to or 2 hours after meals.
-Safety and efficacy have not been established beyond 12 months and 9 months, respectively.

Use: As an adjunct to scaling and root planing to promote attachment level gain and to reduce pocket depth in patients with periodontitis

Usual Adult Dose for Cervicitis

US CDC Recommendations: 100 mg orally twice a day for 7 days

Comments:
-Recommended regimen for presumptive therapy
-Concomitant treatment for gonococcal infection should be considered if patient is at risk for or lives in a community with a high incidence of gonorrhea.
-The patient's sexual partner(s) should also be evaluated/treated.
-Current guidelines should be consulted for additional information.

Usual Adult Dose for Lyme Disease

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 Pediatric Dose for Bartonellosis

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 Anthrax Prophylaxis

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 Granuloma Inguinale

IV:
Less than 45 kg:
All patients with severe or life-threatening infections: 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 granuloma inguinale due to K granulomatis
-For the treatment of lymphogranuloma venereum due to C trachomatis

AAP Recommendations:
8 years or older: 100 mg orally twice a day

Duration of Therapy:
-Granuloma inguinale: At least 3 weeks and until all lesions have completely healed
-Lymphogranuloma venereum: 21 days

Comments:
-Recommended as the drug of choice for granuloma inguinale; gentamicin may be added if no improvement is observed after several days.
-Recommended as the preferred therapy for lymphogranuloma venereum
-The patient's sexual partner(s) should also be evaluated/treated.
-Current guidelines should be consulted for additional information.

Usual Pediatric Dose for Plague

IV:
Less than 45 kg:
All patients with severe or life-threatening infections: 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).

Use: For the treatment of plague due to Y pestis

US CDC 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 or 200 mg orally or IV once a day
Duration of therapy: 10 to 14 days (or until 2 days after fever subsides)

Comments:
-In general, recommended as an alternative regimen for the treatment of plague
-IV therapy should be started as soon as plague suspected; may switch to oral therapy once patient improves
-Current guidelines should be consulted for additional information.

Usual Pediatric Dose for Plague Prophylaxis

US CDC Recommendations:
8 years or older:
-Less than 45 kg: 2.2 mg/kg orally twice a day
-At least 45 kg: 100 mg orally twice a day
Duration of therapy: 7 days

Comments:
-Recommended as a preferred agent for postexposure prophylaxis in patients with known exposure to plague (e.g., close contact with pneumonic plague patient, direct contact with infected body fluids/tissues)
-Current guidelines should be consulted for additional information.

Usual Pediatric Dose for Chlamydia Infection

AAP and US CDC Recommendations:
Adolescents and children 8 years or older: 100 mg orally twice a day for 7 days
-Alternatively for adolescents (delayed-release tablets): 200 mg orally once a day for 7 days

Comments:
-Recommended for uncomplicated anogenital tract infection due to C trachomatis
-The patient's sexual partner(s) should also be evaluated/treated.
-Current guidelines should be consulted for additional information.

Usual Pediatric Dose for Gonococcal Infection - Uncomplicated

US CDC Recommendations:
-Adolescents: 100 mg orally twice a day for 7 days

Comments:
-With ceftriaxone (or cefixime), recommended for uncomplicated infections of the cervix, urethra, or rectum as an alternative second antimicrobial in patients with azithromycin allergy
-The AAP recommends the same dose for patients 8 years or older weighing at least 45 kg.
-The patient's sexual partner(s) should also be evaluated/treated.
-Current guidelines should be consulted for additional information.

Usual Pediatric Dose for Lyme Disease - Carditis

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 STD Prophylaxis

AAP Recommendations:
8 years or older and not pregnant: 100 mg orally twice a day for 7 days

Comments:
-With ceftriaxone, recommended as prophylaxis after sexual assault for dual therapy for gonorrhea and chlamydia
-Current guidelines should be consulted for additional information.

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