Medication | Dose | Route | Usual maximum daily dose | Potential adverse effects and target dose ranges |
Amikacin*¶ | - 15 to 22.5 mg/kg daily or divided in 2 to 3 doses
- 15 to 25 mg/kg per day in 1 dose for 3 times per week dosingΔ
| IV, IM | | - Dizziness; ataxia; vertigo; tinnitus; hearing loss; nephrotoxicity
- For every 8 hour dosing*: Adjust dose for trough <3 to 5 mcg/mL and peak 20 to 25 mcg/mL
- For once daily dosing*: Adjust dose for trough 0.5 to 1 mcg/mL (at 18 hours) and peak 40 to 50 mcg/mL
|
Azithromycin | - 5 to 10 mg/kg per day in 1 dose for daily dosing
- 10 mg/kg per day in 1 dose for 3 times per week dosing
| Oral, IV | - Daily: 300 mg/day
- 3 times per week: 500 mg/day
| - Prolongation of the QT interval; nausea; vomiting; diarrhea; decreased hearing; dizziness; hepatitis; phlebitis (IV)
|
Cefoxitin¶ | - 160 mg/kg per day divided in 4 doses
| IV, IM | | - Bone marrow suppression; interstitial nephritis; hypersensitivity (fever, rash); may interfere with serum creatinine assay (falsely elevates creatinine)
|
Ciprofloxacin¶ | - 20 mg/kg per day divided in 2 doses
| Oral, IV | - Oral: 1.5 g/day
- IV: 1200 mg/day
| - Tendon damage; prolongation of the QT interval; CNS stimulation; nausea; vomiting; diarrhea
|
Clarithromycin¶ | - 15 to 30 mg/kg per day divided in 2 doses (for daily or 3 times per week dosing)Δ
| Oral | | - Prolongation of the QT interval; nausea; vomiting; diarrhea; taste disturbance; decreased hearing; hepatitis◊; anterior uveitis◊; arthralgia◊; granulocytopenia◊; significant drug-drug interactions (particularly with rifamycins)
|
Doxycycline | - 2 to 4 mg/kg per day in 1 or 2 doses
| Oral, IV | | - Tooth discoloration in children <8 years; nausea; vomiting; diarrhea; photosensitivity; rash; hyperpigmentation; phlebitis (IV); and injection site pain (IV)
|
Ethambutol¶ | - 15 mg/kg per day in 1 dose for daily dosing
- 25 mg/kg per day in 1 dose for 3 times per week dosingΔ
| Oral | - Daily: 1 g/day
- 3 times per week: 2.5 g/day
| - Optic neuritis (usually reversible)§; red-green color blindness¥; gastrointestinal disturbances; hypersensitivity
|
Imipenem¶ | - 60 to 100 mg/kg per day in 4 doses
- Adolescents can receive 500 mg to 1 g 2 or 3 times daily
| IV | 4 g/day | - Nausea; vomiting; diarrhea; hypersensitivity; seizures; confusion; hepatitis; leukopenia; anemia; thrombocytopenia
|
Isoniazid | - 5 mg/kg per day for NTM infection
- 10 to 15‡ mg/kg per day in 1 dose if cannot definitively exclude Mycobacterium tuberculosis
| Oral, IM | | - Mild hepatic enzyme elevation; hepatitis‡; peripheral neuritis; hypersensitivity (fever, rash); diarrhea and gastric irritation (caused by vehicle in syrup)
- Pyridoxine supplementation of 1 to 2 mg/kg per day (up to 50 mg/day) is suggested to prevent peripheral neuropathy in exclusively breastfed infants, children and adolescents on meat- and milk-deficient diets, children with nutritional deficiencies, children and adolescents with symptomatic HIV infection, and pregnant adolescents
|
Levofloxacin¶ | - <5 years: 20 mg/kg per day in 2 doses
- ≥5 years: 10 mg/kg once daily
| Oral, IV | | - Tendon damage; CNS stimulation; nausea; vomiting; diarrhea
|
Linezolid | - <12 years: 30 mg/kg per day in 3 doses
- ≥12 years: 600 mg twice per day
| Oral, IV | | - Nausea; vomiting; diarrhea; leukopenia; anemia; thrombocytopenia; pancytopenia; peripheral neuropathy; optic neuritis; serotonin syndrome
|
Meropenem¶ | - <50 kg: 30 to 60 mg/kg per day divided in 3 doses
- ≥50 kg: 3 g/day in 3 divided doses
| IV | | - May lower seizure threshold; bone marrow suppression; interstitial nephritis
|
Moxifloxacin | - 400 mg per day in 1 dose (for adolescents)
| Oral | | - Tendon damage; CNS stimulation; nausea; vomiting; diarrhea
|
Pyrazinamide¶ | - 30 to 40 mg/kg per day for daily dosing
- 50 mg/kg per day for twice weekly dosing
| Oral | | - Arthralgia; gastrointestinal tract upset; hepatotoxicity; hyperuricemia
|
Rifabutin¶† | - 10 to 20 mg/kg per day in 1 dose (for daily or 3 times per week dosing)
| Oral | | - Orange discoloration of secretions (may stain soft contact lenses), urine, and stool; gastrointestinal disturbance; hepatitis◊; "flu-like" syndrome; thrombocytopenia; kidney failure; myalgia; arthralgia◊; granulocytopenia◊; anterior uveitis◊
|
Rifampin (rifampicin)† | - 15 to 20 mg/kg per day in 1 dose (for daily or 3 times per week dosing)
| Oral, IV | - Children weighing <50 kg: 450 mg/day
- Children weighing ≥50 kg: 600 mg/day
| - Orange discoloration of secretions (may stain soft contact lenses), urine, and stool; gastrointestinal disturbance; hepatitis; "flu-like" syndrome; thrombocytopenia; kidney failure; multiple significant drug-drug interactions
|
Streptomycin*¶ | - 20 to 40 mg/kg per day in 1 dose or in 2 divided doses (preferred for IV)
- 15 to 25 mg/kg per day in 1 dose for 3 times per week dosingΔ
| IM, IV (if IM not tolerated) | | - Dizziness; ataxia; vertigo; tinnitus; hearing loss; nephrotoxicity; hypersensitivity reaction
- Adjust dose for trough <3 to 5 mcg/mL and peak 15 to 30 mcg/mL for every 12 hour dosing*
|
Tigecycline | - 8 to 11 years: 2.4 to 4 mg/kg per day in 2 divided doses
- ≥12 years: 50 mg every 12 hours
| IV | | - Nausea; anorexia; vomiting; diarrhea; photosensitivity; coagulopathy; tooth discoloration (in children <8 years of age); phlebitis; injection site pain
|
Tobramycin*¶ | - 7.5 mg/kg per day in 3 doses or 7 mg/kg once daily
| IM, IV | | - Dizziness; ataxia; vertigo; tinnitus; hearing loss; nephrotoxicity
- For every 8 hour dosing*: Adjust dose for trough <1 mcg/mL and peak 6 to 8 mcg/mL
- For once daily dosing*: Adjust dose for trough <1 mcg/mL at 18 hours and peak 15 to 22 mcg/mL
|
Trimethoprim-sulfamethoxazole¶ (TMP-SMX, cotrimoxazole) | - 8 to 12 mg/kg per day of the TMP component divided in 2 doses
| Oral, IV | - 320 mg/day of TMP component
| - Rash; hypersensitivity reaction (fever, rash, Stevens-Johnson syndrome); bone marrow suppression; nausea; vomiting; diarrhea; IV formulation requires substantial dilution, which may result in large volumes (which may be problematic for patients with kidney function impairment or fluid overload)
|