ACTION AND USE. Neomycin sulfate is effective against certain gram-negative and grampositive bacteria. Normally used as a topical preparation for the treatment of skin infections, burn wounds, ulcers, and dermatoses, it may be used orally for reduction of intestinal flora prior to surgery involving the bowel or anus.
USUAL DOSE. 700 mg every 4 hours as prescribed by a physician.
ACTION AND USE. Gentamycin sulfate is indicated in the treatment of serious systemic infections of susceptible gram-negative organisms. While the patient is on gentamycin, it is necessary to monitor renal and hepatic function to determine if toxic levels are reached. Gentamycin is also available as a topical preparation for the treatment of burns and infected wounds, and as an ophthalmic preparation for eye infections.
USUAL DOSE. The recommended dose for patients with serious infections and normal renal function is 3 mg/kg/day in equally divided doses. Gentamycin is normally administered intramuscularly but can be administered intravenously.
The macrolide antibiotics constitute a large group of bacteriostatic agents that inhibit protein synthesis. They are effective against gram-positive cocci, Neisseria, Hemophilus, and mycobacteria. All are similar to penicillin in their antibacterial spectra and are often used in patients who are sensitive to penicillin.
ACTION AND USE. Because it has a bitter taste and is destroyed by gastric acids, erythromycin is usually administered as an enteric coated tablet. Erythromycin is one of the drugs of choice when penicillin is contraindicated. It is also available as an ophthalmic ointment and as a topical preparation for the adjunctive treatment of acne.
USUAL DOSE. 250 mg four times daily or 500 mg twice daily for oral preparations, and 1 g daily by slow intravenous infusion or in four equally divided doses.
ACTION AND USE. The use of clindamycin hydrochloride has often been associated with severe colitis and profuse diarrhea; if this condition occurs, the drug should be discontinued. Clindamycin hydrochloride is indicated in the treatment of susceptible anaerobic organisms. A topical preparation is also available for the treatment of acne.
USUAL DOSE. 150 to 300 mg every 6 hours for the oral form and 600 to 1200 mg per daily in 2, 3, or 4 equally divided doses for the intravenous form.
ACTION AND USE. Vancomycin hydrochloride is bactericidal against many gram-positive bacteria. It is indicated in potentially life-threatening conditions that cannot be treated with less toxic preparations.
USUAL DOSE. 500 mg every 6 hours or 1 g every 12 hours intravenously only; vancomycin hydrochloride can be very irritating and painful when administered intramuscularly.
In addition to the previously mentioned antiinfectives, there are several other agents that are effective in the treatment of different organisms.
ACTION AND USE. Rifampin is indicated in the treatment of pulmonary tuberculosis; it must be used in conjunction with at least one other antituberculosis agent, usually ethambutol or isoniazid.
USUAL DOSE. 600 mg in a single daily administration throughout the course of the disease.
ACTION AND USE. Isoniazid is indicated in the treatment of tuberculosis and as a preventive therapy for high risk persons, i.e., positive tuberculin skin test, family members of a person with tuberculosis, and newly infected persons.