ADULT \PEDIATRIC
Dosing Form & Strengths
tablet
- 250mg
General Dosing Recommendations
250 mg PO q6hr, OR
500 mg PO q12hr (if daily dose does not exceed 1 g)
May increase up to 4 g/day depending on infection severity
Amebiasis
500 mg PO q6hr for 10-14 days
Legionnaires Disease
1-4 g/day PO in divided doses for 21 days
Urethritis
Urethritis caused by C trachomatis or U urealyticum
500 mg PO q6hr for 7 days; alternatively 333 mg PO q8hr for 7 days
Syphilis
30-40 g PO in divided doses for 10-15 days
Renal Impairment
Dose adjustment not necessary
Hepatic Impairment
Use caution
Other Indications & Uses
Group A beta-hemolytic strep, Actinobacillus actinomycetemcomitans, Actinomyces israelii, Actinomyces naeslundii, Actinomyces odontolyticus, Afipia felis, Arachnia propionica, Arcanobacterium (Corynebacterium) haemolyticum, Bacillus anthracis, Bartonella henselae, Bartonella quintana, Bordetella pertussis, Borrelia burgdorferi, Borrelia recurrentis, C. diphtheriae, C. trachomatis, Klebsiella granulomatis, Campylobacter jejuni, Capnocytophaga ochracea, Chlamydia pneumonia (TWAR agent), Chlamydia psittaci, Chlamydia trachomatis, Chryseobacterium meningosepticum, Corynebacterium jeikeium (CDC group JK), Corynebacterium minutissimum, Corynebacterium ulcerans, Coxiella burnetii, E. histolytica, Erysipelothrix rhusiopathiae, H. ducreyi, H. influenzae, Kingella sp., Lactobacillus sp, Legionella pneumophilia, Leptospira interrogans, Leptotrichia buccalis, Leuconostoc species, Listeria, Mycobacterium chelonae, Mycobacterium fortuitum, M. catarrhalis, Mycoplasma pneumoniae, N. gonorrhoeae, Rhodococcus equi, S. aureus, S. pyogenes (group A beta-hemolytic streptococci), S. pneumoniae, Spirillum minus, Streptobacillus moniliformis, Streptococcus (Group C, G), Streptococcus agalactiae (Group B), Streptococcus bovis (Group D), Streptococcus intermedius group (S. anginosus, S intermedius, S. constellatus), Streptococcus pneumoniae (PCN sensitive, MIC <0.1 mcg/mL), Streptococcus pyogenes (Group A), Treponema pallidum, U. urealyticum, Ureaplasma urealyticum, Vibrio cholerae, Viridans streptococci
Off-label: Campylobacter jejuni, Calymmatobacterium granulomatis, Haemophilus ducreyi, prophylaxis in colorectal surgery, anthrax, tetanus, Lyme disease
First line: Afipia felis, Arcanobacterium (Corynebacterium) haemolyticum, Bartonella henselae, Bartonella quintana, Campylobacter jejuni, Capnocytophaga ochracea, Chlamydia pneumonia, Corynebacterium minutissimum, Corynebacterium ulcerans, Haemophilus ducreyi, Mycobacterium fortuitum, Ureaplasma urealyticum (others eg, Haemophilus ducreyi not unanimous)
Adverse Effects
1-10%
Abdominal pain (8%)
Headache (8%)
Nausea (8%)
Diarrhea (7%)
Rash (3%)
Vomiting (3%)
Dyspepsia (2%)
Flatulence (2%)
Pain (2%)
Pruritus (1%)
Pseudomembranous colitis
Hypertrophic pyloric stenosis
Anaphylaxis
Fever
Mild allergic reactions
Urticaria
Skin eruptions
Tinnitus
<1%
Cholestatic hepatitis
Confusion
Hallucinations
Hearing loss
Hypotension
Nervous system effects including seizures
Torsade de pointes
Ventricular tachycardia
Vertigo
Postmarketing reports
Interstitial nephritis
Contraindications
Documented hypersensitivity
Coadministration with terfenadine
Coadministration with HMG-CoA reductase inhibitors that are extensively metabolized by CYP3A4 (lovastatin or simvastatin)
Co-administration of erythromycin with pimozide, ergotamine or dihydroergotamine
Pregnancy & Lactation
Pregnancy Category: B
Lactation: distributed in breast milk, use with caution; AAP categorizes as compatible with breastfeeding
Pregnancy Categories
A: Generally acceptable. Controlled studies in pregnant women show no evidence of fetal risk.
B: May be acceptable. Either animal studies show no risk but human studies not available or animal studies showed minor risks and human studies done and showed no risk.C: Use with caution if benefits outweigh risks. Animal studies show risk and human studies not available or neither animal nor human studies done.
D: Use in LIFE-THREATENING emergencies when no safer drug available. Positive evidence of human fetal risk.
X: Do not use in pregnancy. Risks involved outweigh potential benefits. Safer alternatives exist.