- Severe bacterial infections in adults:
- IV 15-20mg/kg/dose BD/TDS
- Consider starting at 20-35mg/kg/dose *1 in seriously ill patients. Max 3g/dose
- IV 15-20mg/kg/dose BD/TDS
- Severe bacterial infections in children:
- < 7 days (<1.2kg):
- IV 15mg/kg/dose OD
- < 7 days (<1.2kg):
-
- <7 days (1.2-2 kg):
- IV 10-15mg/kg/dose every 12-18 hours
- <7 days (1.2-2 kg):
-
- <7 days old (>2.1 kg):
- IV 10-15mg/kg/dose BD/TDS
- IV 10-15mg/kg/dose BD/TDS
- <7 days old (>2.1 kg):
-
- ≥7 days (<1.2kg):
- IV 15mg/kg/dose OD
- IV 15mg/kg/dose OD
- ≥7 days (<1.2kg):
-
- ≥7 days (1.2-2 kg):
- IV 10-15mg/kg/dose BD/TDS
- IV 10-15mg/kg/dose BD/TDS
- ≥7 days (1.2-2 kg):
-
- ≥7 days(>2.1 kg):
- IV 15-20mg/kg/dose TDS
- IV 15-20mg/kg/dose TDS
- ≥7 days(>2.1 kg):
-
- 1-3 months:
- IV 10-15mg/kg/dose TDS/QID. Max: 1 g/dose
- IV 10-15mg/kg/dose TDS/QID. Max: 1 g/dose
- 1-3 months:
-
- 4 months-11 years:
- IV 60-80mg/kg/day divided TDS/QID. Max: 100mg/kg/day
- IV 60-80mg/kg/day divided TDS/QID. Max: 100mg/kg/day
- 4 months-11 years:
-
- ≥12 years: IV 1000mg BD OR 10-15mg/kg/dose BD
- C.difficile infection:
- Non-fulminant:
- PO 125mg QID *10/7
- Non-fulminant:
-
- Fulminant:
- Adults: PO/NG 500mg QID
- Children: PO/PR 40mg/kg/day divided QID *10/7. Max: 500mg/dose
- Fulminant:
-
- 1st recurrence:
- PO 125mg QID *10-14 days, then 125mg BD *1/52, then 125mg OD *1/52, then 125mg every 2-3 days for 2-8 weeks
- May give PO 125mg QID *10/7 if metronidazole initial regimen
- 1st recurrence:
-
- 2nd recurrence:
- Adults: PO 125mg QID *10-14 days, then 125mg BD *1/52, then 125mg OD *1/52, then 125mg every 2-3 days *2-8 weeks OR PO 125mg QID *10/7, then rifaximin *20/7
- Adults: PO 125mg QID *10-14 days, then 125mg BD *1/52, then 125mg OD *1/52, then 125mg every 2-3 days *2-8 weeks OR PO 125mg QID *10/7, then rifaximin *20/7
- 2nd recurrence:
-
-
- Children: PO 10mg/kg/dose QID *14/7, then 10mg/kg/dose BD *7-14 days, then 10mg/kg/dose OD *7-14 days, then 10mg/kg/dose OD for 2-3 days *2-8 weeks. Max: 125 mg/dose OR 10mg/kg/dose QID *1/52, then 10mg/kg/dose TDS *1/52, then 10mg/kg/dose BD *1/52, then 10mg/kg/dose OD *1/52, then 10mg/kg/dose every 2 days *1/7, then 10mg/kg/dose every 3 days *1/52
- 10mg/kg/dose QID *14/7, then rifaximin *14/7 or nitazoxanide *10/7
- 10mg/kg/dose QID *14/7, then rifaximin *14/7 or nitazoxanide *10/7
- Children: PO 10mg/kg/dose QID *14/7, then 10mg/kg/dose BD *7-14 days, then 10mg/kg/dose OD *7-14 days, then 10mg/kg/dose OD for 2-3 days *2-8 weeks. Max: 125 mg/dose OR 10mg/kg/dose QID *1/52, then 10mg/kg/dose TDS *1/52, then 10mg/kg/dose BD *1/52, then 10mg/kg/dose OD *1/52, then 10mg/kg/dose every 2 days *1/7, then 10mg/kg/dose every 3 days *1/52
-
-
- Non-severe in children:
- PO 40mg/kg/day divided QID *10/7
- Max: 125mg/dose
- Non-severe in children:
- Staphylococcal enterocolitis:
- Adults:
- PO 500-2000mg/day divided TDS/QID *7-10 days
- PO 500-2000mg/day divided TDS/QID *7-10 days
- Adults:
-
- Children:
- PO 40mg/kg/day divided TDS/QID *7-10 days
- Max: 500mg/dose, 2000mg/day
- Children:
- Community or hospital-acquired pneumonia:
- Adults:
- IV 15-20mg/kg/dose divided BD/TDS *1/52
- Consider starting IV 20-35mg/kg/dose IV *1 in seriously ill patients. Max 3g/dose
- Adults:
-
- Children >3months:
- IV 40-60mg/kg/day divided TDS/QID *10-14 days
- IV 40-60mg/kg/day divided TDS/QID *10-14 days
- Children >3months:
- Endocarditis:
- Adults:
- IV 15-20mg/kg/dose divided BD/TDS for at least 4 weeks
- Consider starting 20-35mg/kg/dose *1 in seriously ill patients, max 3g/dose
- Adults:
-
- Children:
- IV 40-60mg/kg/day divided BD/QID *4-6 weeks
- IV 40-60mg/kg/day divided BD/QID *4-6 weeks
- Children:
- Systemic anthrax (Off-label):
- Adults:
- IV 60mg/kg/day divided TDS for at least 2 weeks
- May be part of multi-drug regimen including gentamicin gram positive synergy
- Consider starting 20-35mg/kg/dose *1 in seriously ill patients, max 3g/dose
- Adults:
-
- Children:
- Neonates >32 weeks gestation: IV 10-20mg/kg/dose every 12-48 hours for at least 2 weeks
- Neonates >32 weeks gestation: IV 10-20mg/kg/dose every 12-48 hours for at least 2 weeks
- Children:
-
-
- ≥1 month: IV 60mg/kg/day divided TDS for at least 2 weeks
- ≥1 month: IV 60mg/kg/day divided TDS for at least 2 weeks
-
- Bacterial endophthalmitis (Off-label):
- Adults and children ≥2 months: 1mg in 0.1ml sterile water or saline intravitreally *1
- May repeat every 48 hours *1
- Part of multi-drug regimen
- Adults and children ≥2 months: 1mg in 0.1ml sterile water or saline intravitreally *1
- Bacterial meningitis (Off-label):
- IV 15-20mg/kg/dose BD/TDS
- Part of multi-drug regimen
- Consider starting 20-35mg/kg/dose *1 in seriously ill patients, max 3g/dose
Injection: 500mg
- IV form may be given orally
- To be taken with food if used orally
- IV administration given preferably intermittently over 60 minutes. Max 10mg/min
- IV administration can also be administered continuously over 24 hours
Glycopeptide
It inhibits cell-wall biosynthesis by blocking glycopeptide polymerization by binding tightly to D-alanyl-D-alanine portion of cell wall precursor
- Vancomycin flushing syndrome (rapid IV use)
- Hypotension (rapid IV use)
- Fever
- Nausea
- Rigors
- Eosinophilia
- Rash
- Urticaria
- Phlebitis
- Tinnitus
- Dizziness
- Vertigo
- Elevated BUN or Cr
- Vomiting (PO use)
- Flatulence (PO use)
- Hypersensitivity to class/components
- Intraocular prophylaxis use during cataract surgery
WARNING
Single-dose flexible bags are not recommended for use during pregnancy because it contains the excipients polyethylene glycol (PEG) 400 and N-acetyl-D-alanine (NADA), which caused fetal malformations in animal reproduction studies
- Cidofovir
Drug Status
Availability | Prescription only |
Pregnancy | Weigh risk vs benefit |
Breastfeeding | Can be used |
Schedule | Not controlled |
BRAND NAME | STRENGTH | FORMULATION | PACK SIZE | MANUFACTURER | DISTRIBUTOR |
---|---|---|---|---|---|
Vamocin | 500mg | Injection | 1’s | Gufic Stridden | Europa Healthcare |
Vancocin | 500mg | Injection | 1’s | Eli Lilly | Statim Pharma |
Vancolon | 500mg | Injection | 1’s | Julphar Pharma | Pharmamed Solution |
Vencozed | 500mg | Injection | 1’s | Zawadi Healthcare | Zawadi Healthcare |