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FPM > Anti-Infectives Dosing > Flashcards

Anti-Infectives Dosing Flashcards

1
Q

What is the initial conventional dosing of gentamicin?

A

1.5-2mg/kg per dose Q8H based on ideal or adjust body weight

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2
Q

What is the initial extended-interval dosing of gentamicin?

A

5-7mg/kg per day based on ideal or adjust body weight

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3
Q

What is the renal dosage adjustment for gentamicin?

A

Individualized based on CrCL and therapeutic drug monitoring

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4
Q

What peak ranges are associated with efficacy for gentamicin?

A

5-10mcg/mL

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5
Q

What trough ranges are associated with decreased nephrotoxicity for gentamicin?

A

Less than 1-2mcg/mL

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6
Q

How is gentamicin extended interval dosing monitored?

A

Via nomograms with concentrations measured 6-14 hours from time of administration

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7
Q

How does tobramycin IV dosing compare to gentamicin?

A

Same

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8
Q

What is tobramycin inhalation dosing for preventing exacerbations in cystic fibrosis patients?

A

300mg every 12 hours

-should not be used as monotherapy to treat pneumonia

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9
Q

Which organism does tobramycin have slightly better activity against vs gentamicin?

A

Pseudomonas aeruginosa

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10
Q

Which organism does gentamicin have slightly better activity against vs tobramycin?

A
  • Klebsiella pneumoniae

- Gram positive organisms

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11
Q

What is the adult dosing of cefprozil?

A

250-500mg BID

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12
Q

What is the pediatric dosing of cefprozil?

A

7.5mg/kg BID
or
20mg/kg daily, depending on the indication

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13
Q

What is the renal dosage adjustment of cefprozil?

A

Reduce dose by 50% with a CrCL less than 30 mL/min

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14
Q

What is the adult dosing of cefdinir?

A

Most indications: 300mg BID
or
600mg QD

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15
Q

What is the pediatric dosing of cefdinir?

A

7mg/kg/dose BID
or
14mg/kg/dose QD

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16
Q

What is the renal dosage adjustment of cefdinir?

A

300mg QD if CrCL less than 30 mL/min

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17
Q

What is the adult ceftriaxone dosing for most indications?

A

1-2g QD

Maximum daily dose of 4g

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18
Q

What is the adult ceftriaxone dosing for meningitis?

A

2g IV Q12H

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19
Q

What is the adult ceftriaxone dosing for gonorrhea?

A

250mg IM once

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20
Q

What is the pediatric ceftriaxone dosing for mild to moderate infections?

A

50-75mg/kg daily (divided QD or BID)

Maximum daily dose of 2g

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21
Q

What is the pediatric ceftriaxone dosing for meningitis?

A

100mg/kg daily (divided QD or BID)

Maximum daily dose of 4g

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22
Q

What is the adult cefuroxime dosing for most indications?

A

250-500mg BID

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23
Q

What is the pediatric (younger than 12 yo) cefuroxime dosing for most indications?

A

20-30mg/kg/day divided into 2 doses

Max daily dose: 1g

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24
Q

What is the renal dosage adjustment of cefuroxime?

A

Dose every 24 hours with a CrCL less than 30mL/min

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25
Q

What is the adult cephalexin dosing for most indications?

A

1-4g daily in divided doses

Most commonly: 250mg QID

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26
Q

What is the pediatric cephalexin dosing for most indications?

A

25-100mg/kg/day in 2-4 divided doses (max daily dose: 4g)

27
Q

What is the pediatric cephalexin dosing for acute otitis media?

A

75-100mg/kg/day in 4 divided doses

28
Q

What is the renal dosage adjustment of cephalexin?

A

Adjust for CrCL less than 60mL/min

29
Q

What is the adult cefepime dosing for most indications?

A

2g Q8-12H

30
Q

What is the pediatric cefepime dosing for most indications?

A

50mg/kg/dose Q8-12H

Maximum: 2g/dose

31
Q

What is the renal dosage adjustment of cefepime?

A

Adjust for CrCL less than 60mL/min

32
Q

What two indications does cefuroxime have that cefprozil does not have?

A
  • UTIs

- Lyme disease

33
Q

What indications do cefprozil and cefuroxime share?

A
  • upper and lower RTIs
  • uncomplicated skin/structure infections
  • tonsillitis
34
Q

What indications does ceftriaxone have?

A
  • upper/lower RTIs
  • skin/structure infections
  • UTIs
  • gonorrhea
  • pelvic inflammatory disease
  • bacteremia
  • endocarditis
  • bone/joint infections
  • intra-abdominal infections
  • meningitis
  • surgical prophylaxis
  • Lyme disease
35
Q

What is daptomycin dosing for skin/structure infections?

A

4mg/kg daily

36
Q

What is daptomycin dosing for bacteremia and endocarditis?

A

6mg/kg daily

37
Q

What dose of daptomycin is recommended by some experts in cases of complicated MRSA bacteremia and endocarditis?

A

8-10mg/kg daily

38
Q

What is the renal dosage adjustment of daptomycin?

A

Administer QOD if CrCL less than 30mL/min

39
Q

What is the adult oral ciprofloxacin dosing for most indications?

A

250-750mg BID depending on location and severity of infection

40
Q

What is the adult oral ER ciprofloxacin dosing for UTIs?

A

500-1000mg daily

41
Q

What is the adult IV ciprofloxacin dosing for most indications?

A

200-400mg BID or TID depending on location and severity of infection

42
Q

What is the renal dosage adjustment of ciprofloxacin?

A

Required with CrCL of less than 30-50mL/min

43
Q

What is the adult oral levofloxacin dosing for most indications?

A

250-750mg QD depending on indication

44
Q

What is the renal dosage adjustment of levofloxacin?

A

Decreased dose depending on whether CrCL is 20-49mL/min or 10-19mL/min

45
Q

What is the adult oral moxifloxacin dosing for most indications?

A

400mg QD

46
Q

What is the renal dosage adjustment of moxifloxacin?

A

Not necessary

-excreted via the biliary tract

47
Q

What is the adult Bactrim dosing for most indications?

A

1 DS tablet BID

48
Q

What is the adult Bactrim dosing for UTIs?

A

1 DS tablet BID

49
Q

What is the adult Bactrim dosing for Pneumocystis prophylaxis?

A

1 DS tablet QD or TIW

1 SS tablet QD

50
Q

What is the adult Bactrim dosing for Toxoplasmosis prophylaxis?

A

1 DS tablet QD

51
Q

What is the adult Bactrim dosing for Toxoplasmosis treatment?

A

5mg/kg BID

52
Q

What is the adult Bactrim dosing for P. jirovecci pneumonia?

A

15-20mg/kg/day based on trimethoprim divided TID-QID

53
Q

What is the pediatric Bactrim dosing for most indications?

A

8-10mg/kg/day based on trimethoprim divided TID-QID

54
Q

What is the pediatric Bactrim dosing for P. jirovecci pneumonia?

A

Same as adult dosing

55
Q

What is the renal dosage adjustment of Bactrim?

A

50% of usual dose if CrCL of 15-30mL/min

56
Q

What is the oral vancomycin dosing?

A

125-500mg Q6H

57
Q

What is the adult injection vancomycin dosing?

A

15-20mg/kg BID

58
Q

What is the pediatric injection vancomycin dosing?

A

10mg/kg/dose Q6H

59
Q

What is the infant injection vancomycin dosing?

A

Loading dose: 15mg/kg
Followed by:
-10mg/kg Q12H (first week of life)
-10mg/kg Q8H (1 week to 1 month of life)

60
Q

What is vancomycin dosing determined by?

A
  • patient characteristics
  • infection severity
  • renal function
61
Q

What is the renal dosage adjustment of vancomycin?

A

Most clinicians reduce IV dose at CrCL of 50-60mL/min

62
Q

What is a therapeutic vancomycin trough?

A

10-20mg/L
Depends on:
-characteristics of infecting organism
-type of infection

63
Q

What vancomycin troughs are associated with nephrotoxicity?

A

Greater than 15-20mg/L

64
Q

Are vancomycin peaks routinely monitored?

A

No

-evidence correlating concentrations with efficacy is imperfect

FPM (8 decks)

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