Douglas J. Rhee, MD

clarithromycin Biaxin 250–500 mg PO BID Adult dose15 mg/kg/day PO divided BID Pediatric dosedoxycycline Vibramycin 100 mg PO BID Preferred first line agentNot for children or pregnancyerythromycin E-mycin 250 mg PO QID Adult dose30–50 mg/kg/day in 3–4 divided doses Pediatric dosetetracycline Achromycin 250 mg PO QID Not for children or pregnancy(b) Stage 2Develops in days to months, dissemination of organism to skin, heart, joints and CNS. Ocular involvement consists of granulomatousanterior uveitis, retinal vasculitis, choroiditis.) Select one agent—patient needs systemic work-up to rule out arthritis, which must be treatedwith ceftriaxone or doxycycline.Drug Trade Dose Notescefotaxime Claforan 3 gm IV Q12 hr × 21–28 daysceftriaxone Rocephin 2.0 gm IV QD × 21–28 days Preferred first line agent50–75 mg/kg/day divided Q12 hr Pediatric dose (max 2 g/day)doxycycline Vibramycin 100 mg PO BID Preferred first line agentNot for children or pregnancypenicillin G 2–4 MU IV Q4 hr × 21–28 daysAntibacterial Agents 13