II. Indications

  1. Activity
    1. Broad Gram Negative and Gram Positive coverage
    2. May cover organisms resistant to other Antibiotics
      1. Methicillin-resistant Staphylococcus aureus
      2. Vancomycin-resistant Enterococcus species
      3. Acinetobacter baumannii
      4. ESBL Gram-Negative Bacteria
  2. Conditions
    1. Community Acquired Pneumonia
      1. Avoid in Hospital Acquired Pneumonia
      2. Avoid in Ventilator Associated Pneumonia
    2. Complicated Intraabdominal Infections
      1. Avoid in intestinal perforation
    3. Complicated Skin Infections
      1. Avoid in Diabetic Foot Infections

III. Contraindications

  1. Pregnancy
  2. Children age <8 years
    1. Relatively contraindicated as well in age <17 years

IV. Mechanism

  1. See Tetracyclines
  2. Broad-spectrum glycylcycline Antibiotic derived from Tetracycline

V. Dosing: Adult

  1. Reconstituted Intravenous Fluid should have a yellow orange coloration
  2. Load: 100 mg IV infused over 30 to 60 minutes
  3. Next: 50 mg IV infused over 30 to 60 minutes every 12 hours
    1. Decrease dose to 25 mg IV in Child-Pugh C severe liver disease

VI. Dosing: Child

  1. Avoid in children in general unless no other alternative agent
    1. Absolutely contraindicated in children <8 years old
  2. Age 8 to 11 years
    1. Give 1.2 mg/kg (up to 50 mg) IV every 12 hours
  3. Age 12 to 17 years
    1. Give 50 mg IV every 12 hours

VII. Adverse Effects

VIII. Safety

  1. Pregnancy Category D
  2. Unknown safety in Lactation

IX. Drug Interactions

  1. Warfarin
    1. May increase INR

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