-Dialysis does not alter the serum half-life of this drug. AHA Recommendations: ---More severe infections: 100 mg orally every 12 hours -If parenteral therapy is used initially, may switch to oral therapy when clinically indicated Comments: Comments: -Patients exposed to aerosolized spores will require prophylaxis to complete an antimicrobial regimen of 60 days from onset of illness. -Patients should be clinically monitored until signs/symptoms have resolved. -Oral: Infections due to penicillinase-producing organisms -Antibiotic prophylaxis may be used for dental procedures (involving manipulation of gingival tissues or periapical region of teeth or perforation of oral mucosa), respiratory tract procedures, or procedures on infected skin, skin structures, or musculoskeletal tissue only for patients with the highest risk of infective endocarditis. -The 20 mg capsule or tablet formulation -Parenteral: Reserve this formulation for moderately severe and severe infections and for patients unable to take oral formulations; may switch to oral formulation as soon as appropriate IV: ORAL: -With other agents, recommended as part of a parenteral regimen or as part of an IM/oral regimen; also recommended as part of an alternative parenteral regimen -For the treatment of the following infections: Psittacosis (ornithosis) due to Chlamydophila psittaci; chancroid due to Haemophilus ducreyi; relapsing fever due to Borrelia recurrentis; Campylobacter fetus infections; bartonellosis due to Bartonella bacilliformis; trachoma or inclusion conjunctivitis due to Chlamydia trachomatis; respiratory tract infections due to Mycoplasma pneumoniae Uses: For the treatment of rickettsial infections including RMSF, typhus fever and the typhus group, Q fever, rickettsialpox, and tick fevers due to Rickettsia species -The patient's sexual partner(s) should also be evaluated/treated. -Current guidelines should be consulted for additional information. -Alternatively for adolescents (delayed-release tablets): 200 mg orally once a day for 7 days -Recommended oral or IV therapy for infections after animal bites -The patient's sexual partner(s) should also be evaluated/treated. Rifampin is usually well tolerated and produces few adverse effects. Severe malaria: Less than 45 kg: -These regimens (100 mg orally twice a day and 200 mg orally once a day) have been recommended by the US CDC for the treatment of chlamydial infections; current guidelines should be consulted for additional information. -Initial dose: 200 mg orally on the first day, given in 2 divided doses (100 mg every 12 hours) -Oral: For the treatment of gastrointestinal tract infections due to Shigella, Salmonella species (including S typhi), E coli, P mirabilis, and enterococci; for the treatment of genitourinary tract infections due to E coli, P mirabilis, enterococci, Shigella, Salmonella species (including S typhi). Applies to the following strengths: 250 mg; 500 mg; 125 mg/5 mL; 250 mg/5 mL; 125 mg; 1 g; 2 g; 10 g. The manufacturer gives no specific dosing instructions. -With quinine and primaquine, recommended for uncomplicated malaria due to chloroquine-resistant P vivax -As adjunctive therapy for: Acute intestinal amebiasis; severe acne -Cardiac disease: 14 to 21 days Doryx(R) MPC: -Recommended as an alternative IV regimen for the treatment of tularemia in a contained casualty setting and for postexposure prophylaxis -Systemic anthrax with possible/confirmed meningitis (1 month or older): At least 2 to 3 weeks or until patient is clinically stable (whichever is longer) -Initial dose: 5.3 mg/kg orally on the first day, given in 2 divided doses

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