Matching articles for "penicillin"
Antibiotic Prophylaxis for Dental Procedures
The Medical Letter on Drugs and Therapeutics • April 29, 2024; (Issue 1701)
Since 2007, antimicrobial prophylaxis for dental
procedures has been recommended to prevent
viridans group streptococcal infective endocarditis
only for patients at highest risk of an adverse
outcome....
Since 2007, antimicrobial prophylaxis for dental
procedures has been recommended to prevent
viridans group streptococcal infective endocarditis
only for patients at highest risk of an adverse
outcome. Limiting use to such patients does not
appear to have led to an increased incidence of
infective endocarditis or increased mortality due to
infective endocarditis.
Treatment of Common Respiratory Tract Infections
The Medical Letter on Drugs and Therapeutics • April 17, 2023; (Issue 1674)
Most respiratory tract infections are caused by
viruses. Bacterial respiratory tract infections are
usually treated empirically with antibiotic therapy
that targets the most probable causative...
Most respiratory tract infections are caused by
viruses. Bacterial respiratory tract infections are
usually treated empirically with antibiotic therapy
that targets the most probable causative pathogens.
Recommended antibiotic regimens for outpatient
treatment of some common respiratory tract
infections are listed in Table 1 for adults and Table 2
for children.
Drugs for Sexually Transmitted Infections
The Medical Letter on Drugs and Therapeutics • June 27, 2022; (Issue 1653)
This article includes recommendations for management
of most sexually transmitted infections (STIs)
other than HIV and viral hepatitis. Some of the
indications and dosages recommended here have
not been...
This article includes recommendations for management
of most sexually transmitted infections (STIs)
other than HIV and viral hepatitis. Some of the
indications and dosages recommended here have
not been approved by the FDA (see Table 1).
Antibacterial Drugs for Lyme Disease
The Medical Letter on Drugs and Therapeutics • May 17, 2021; (Issue 1624)
Lyme disease in the US is caused by the spirochete
Borrelia burgdorferi, which is transmitted to humans
by Ixodes scapularis (blacklegged [deer] tick) and
I. pacificus (western blacklegged tick). Most cases...
Lyme disease in the US is caused by the spirochete
Borrelia burgdorferi, which is transmitted to humans
by Ixodes scapularis (blacklegged [deer] tick) and
I. pacificus (western blacklegged tick). Most cases of
Lyme disease occur in late spring and early summer
in northeastern and mid-Atlantic states, the upper
Midwest, and in northern California. B. mayonii, which
is also transmitted by I. scapularis, has been shown to
cause a similar illness in the upper Midwest.
Antibacterial Drugs for Community-Acquired Pneumonia
The Medical Letter on Drugs and Therapeutics • January 25, 2021; (Issue 1616)
Treatment of community-acquired pneumonia (CAP)
is usually empiric, with selected antibiotic regimens
directed against some of the most common causative
pathogens. Recommended empiric regimens are
listed in...
Treatment of community-acquired pneumonia (CAP)
is usually empiric, with selected antibiotic regimens
directed against some of the most common causative
pathogens. Recommended empiric regimens are
listed in Table 2; recommended antibiotic dosages for
treatment of CAP are listed in Tables 3 and 4. Joint
guidelines for treatment of CAP by the American
Thoracic Society and the Infectious Diseases Society of
America (ATS/IDSA) were updated in 2019.
Cefiderocol (Fetroja) - A New IV Cephalosporin for Complicated UTI
The Medical Letter on Drugs and Therapeutics • May 4, 2020; (Issue 1597)
The FDA has approved cefiderocol (Fetroja – Shionogi),
a new IV cephalosporin antibiotic, for treatment of
complicated urinary tract infections (UTI) caused by
susceptible gram-negative bacteria in adults...
The FDA has approved cefiderocol (Fetroja – Shionogi),
a new IV cephalosporin antibiotic, for treatment of
complicated urinary tract infections (UTI) caused by
susceptible gram-negative bacteria in adults who
have limited or no alternative treatment options.
Eravacycline (Xerava) - An IV Tetracycline for Complicated Intra-Abdominal Infections
The Medical Letter on Drugs and Therapeutics • April 22, 2019; (Issue 1570)
Eravacycline (Xerava – Tetraphase), a new synthetic
tetracycline antibiotic, has been approved by the
FDA for IV treatment of complicated intra-abdominal
infections (cIAIs) in adults. Eravacycline is...
Eravacycline (Xerava – Tetraphase), a new synthetic
tetracycline antibiotic, has been approved by the
FDA for IV treatment of complicated intra-abdominal
infections (cIAIs) in adults. Eravacycline is structurally
similar to tigecycline (Tygacil, and generics), a broad-spectrum
tetracycline approved by the FDA for IV
treatment of complicated skin and skin structure
infections, complicated intra-abdominal infections,
and community-acquired pneumonia. A higher rate
of mortality has been reported with use of tigecycline
compared to other antibacterial drugs; it should be
used only when no suitable alternative is available.
Clarithromycin in Patients with Coronary Artery Disease
The Medical Letter on Drugs and Therapeutics • May 21, 2018; (Issue 1547)
The FDA has warned that use of the macrolide
antibiotic clarithromycin (Biaxin, and generics) may
increase the risk of cardiovascular morbidity and
mortality in patients with heart...
The FDA has warned that use of the macrolide
antibiotic clarithromycin (Biaxin, and generics) may
increase the risk of cardiovascular morbidity and
mortality in patients with heart disease.
Delafloxacin (Baxdela) - A New Fluoroquinolone Antibiotic
The Medical Letter on Drugs and Therapeutics • March 26, 2018; (Issue 1543)
The FDA has approved delafloxacin (Baxdela –
Melinta), an anionic fluoroquinolone antibiotic, for oral
and parenteral treatment of adults with acute bacterial
skin and skin structure infections (ABSSSIs),...
The FDA has approved delafloxacin (Baxdela –
Melinta), an anionic fluoroquinolone antibiotic, for oral
and parenteral treatment of adults with acute bacterial
skin and skin structure infections (ABSSSIs), including
those caused by methicillin-resistant Staphylococcus
aureus (MRSA). It is the first fluoroquinolone to be
approved for treatment of MRSA.
Drugs for Common Bacterial Infections in Adults
The Medical Letter on Drugs and Therapeutics • October 23, 2017; (Issue 1532)
Bacterial infections in adults are generally treated
empirically, with the antibiotic covering most, but not
all, of the potential causative pathogens. For some
infections, culture and sensitivity testing...
Bacterial infections in adults are generally treated
empirically, with the antibiotic covering most, but not
all, of the potential causative pathogens. For some
infections, culture and sensitivity testing can guide
treatment, allowing for use of narrower-spectrum
antibiotics. The recommended dosages and durations
of antibiotic treatment for common respiratory, skin, and
urinary tract infections are listed in Tables 1-3. Infectious
disease experts now recommend shorter treatment
durations for many infections to reduce the development
of antimicrobial resistance and minimize adverse effects.
Drugs for Sexually Transmitted Infections
The Medical Letter on Drugs and Therapeutics • July 3, 2017; (Issue 1524)
The text and tables that follow include recommendations
for management of sexually transmitted
infections (STIs) other than HIV and viral hepatitis.
Some of the indications and dosages recommended
here have...
The text and tables that follow include recommendations
for management of sexually transmitted
infections (STIs) other than HIV and viral hepatitis.
Some of the indications and dosages recommended
here have not been approved by the FDA.
Alternatives to Fluoroquinolones
The Medical Letter on Drugs and Therapeutics • June 6, 2016; (Issue 1496)
The FDA has announced that it is requiring changes in
the labeling of systemic fluoroquinolones to warn that
the risk of serious adverse effects, including tendinitis,
peripheral neuropathy and CNS effects,...
The FDA has announced that it is requiring changes in
the labeling of systemic fluoroquinolones to warn that
the risk of serious adverse effects, including tendinitis,
peripheral neuropathy and CNS effects, generally outweighs
their benefit for the treatment of acute sinusitis,
acute exacerbations of chronic bronchitis, and uncomplicated
urinary tract infections. For these infections, the
new labels will recommend reserving fluoroquinolones
for patients with no other treatment options.
Ceftolozane/Tazobactam (Zerbaxa) - A New Intravenous Antibiotic
The Medical Letter on Drugs and Therapeutics • March 2, 2015; (Issue 1463)
The FDA has approved ceftolozane/tazobactam
(Zerbaxa – Cubist), a combination of a new cephalosporin
antibiotic and a beta-lactamase inhibitor, for
intravenous treatment of complicated urinary tract
and...
The FDA has approved ceftolozane/tazobactam
(Zerbaxa – Cubist), a combination of a new cephalosporin
antibiotic and a beta-lactamase inhibitor, for
intravenous treatment of complicated urinary tract
and intra-abdominal infections in adults.
Oritavancin (Orbactiv) for Skin and Skin Structure Infections
The Medical Letter on Drugs and Therapeutics • January 5, 2015; (Issue 1459)
The FDA has approved oritavancin (Orbactiv – The
Medicines Company), a long-acting lipoglycopeptide
antibiotic given as a single intravenous (IV) dose, for
treatment of acute bacterial skin and skin...
The FDA has approved oritavancin (Orbactiv – The
Medicines Company), a long-acting lipoglycopeptide
antibiotic given as a single intravenous (IV) dose, for
treatment of acute bacterial skin and skin structure
infections caused by susceptible gram-positive
bacteria in adults. It is the third lipoglycopeptide
antibiotic to be marketed in the US; telavancin (Vibativ)
and dalbavancin (Dalvance) were approved earlier.
Drugs for Sexually Transmitted Infections
The Medical Letter on Drugs and Therapeutics • September 1, 2013; (Issue 133)
Many infections can be transmitted during sexual contact.
The text and tables that follow include recommendations
for management of sexually transmitted
infections (STIs) other than HIV, viral hepatitis,...
Many infections can be transmitted during sexual contact.
The text and tables that follow include recommendations
for management of sexually transmitted
infections (STIs) other than HIV, viral hepatitis, and
enteric infections. Some of the indications and
dosages recommended here have not been approved
by the FDA.
Drugs for Bacterial Infections
The Medical Letter on Drugs and Therapeutics • July 1, 2013; (Issue 131)
The text that follows reviews some common bacterial
infections and their empiric treatment pending the
results of culture and susceptibility testing. The recommendations
made here are based on the results...
The text that follows reviews some common bacterial
infections and their empiric treatment pending the
results of culture and susceptibility testing. The recommendations
made here are based on the results of
susceptibility studies, clinical trials, and the opinions
of Medical Letter reviewers. Tables 1 and 2 list the usual
dosages of antibacterial drugs.
Addendum: Cephalosporins for Patients with Penicillin Allergy
The Medical Letter on Drugs and Therapeutics • February 18, 2013; (Issue 1410)
A reader who took the online continuing medical education (CME) exam for issue 1406 (Med Lett Drugs Ther 2012; 54:101) pointed out that the first question assumed that a rash following oral administration of...
A reader who took the online continuing medical education (CME) exam for issue 1406 (Med Lett Drugs Ther 2012; 54:101) pointed out that the first question assumed that a rash following oral administration of ampicillin would be due to allergy. Perhaps we should have mentioned in our article on penicillin allergy that late-appearing maculopapular rashes associated with oral ampicillin or amoxicillin are generally considered non-allergic and need not preclude subsequent administration of ampicillin or amoxicillin.
Cephalosporins for Patients with Penicillin Allergy
The Medical Letter on Drugs and Therapeutics • December 24, 2012; (Issue 1406)
Only a small minority of patients who say they are
allergic to penicillin will have a reaction if they take...
Only a small minority of patients who say they are
allergic to penicillin will have a reaction if they take a
penicillin.
Levofloxacin Revisited
The Medical Letter on Drugs and Therapeutics • July 11, 2011; (Issue 1368)
A Medical Letter reader has asked us to review the
safety of the fluoroquinolone antibiotic levofloxacin
(Levaquin – Ortho-McNeil-Janssen), which has just
been approved for generic use by the FDA and...
A Medical Letter reader has asked us to review the
safety of the fluoroquinolone antibiotic levofloxacin
(Levaquin – Ortho-McNeil-Janssen), which has just
been approved for generic use by the FDA and has
been at the center of some recent lawsuits regarding
the adequacy of its safety warnings.
In Brief: Extended-Release Amoxicillin for Strep Throat
The Medical Letter on Drugs and Therapeutics • March 9, 2009; (Issue 1307)
The FDA has approved an extended-release formulation of amoxicillin (Moxatag – MiddleBrook) for once-daily treatment of pharyngitis or tonsillitis caused by Streptococcus pyogenes in adults and children ≥12...
The FDA has approved an extended-release formulation of amoxicillin (Moxatag – MiddleBrook) for once-daily treatment of pharyngitis or tonsillitis caused by Streptococcus pyogenes in adults and children ≥12 years old. Approval was based on an unpublished study that found once-daily treatment with Moxatag 775 mg for 10 days non-inferior to penicillin V 250 mg four times a day for 10 days in eradication of S. pyogenes.
For decades, the drug of choice for oral treatment of streptococcal pharyngitis in adolescents and adults has been penicillin V 250 mg taken three or four times a day.1 Amoxicillin is equally effective, but penicillin is generally recommended because of its narrower spectrum. In adults, immediate-release amoxicillin is usually dosed 375-500 mg two to three times a day, but giving it in a higher dose (750-1000 mg) once a day appears to be equally effective for treatment of strep throat.2-4
Each Moxatag tablet contains 775 mg of amoxicillin divided into one immediate-release and two delayedrelease components. Compared to a similar dose of immediate-release amoxicillin suspension, absorption of amoxicillin from the new formulation is slower, resulting in a lower peak serum concentration, but the elimination half-life and amoxicillin exposure (AUC) are similar. S. pyogenes is susceptible to these serum concentrations, but they may be too low to treat other types of infections.
A 10-day supply of Moxatag is expected to cost about $100 compared to $4 for a similar course of penicillin V or immediate-release amoxicillin.5 There is no good reason to prescribe Moxatag.
1. A Bisno et al. Practice guidelines for the diagnosis and management of group A streptococcal pharyngitis. Infectious Disease Society of America. Clin Infect Dis 2002; 35:113.
2. P Shvartzman et al. Treatment of streptococcal pharyngitis with amoxycillin once a day. BMJ 1993; 306:1170.
3. HM Feder Jr. et al. Once-daily therapy for streptococcal pharyngitis with amoxicillin. Pediatrics 1999; 103:47.
4. HW Clegg et al. Treatment of streptococcal pharyngitis with once-daily compared with twice-daily amoxicillin: a noninferiority trial. Pediatr Infect Dis J 2006; 25:761.
5. Retail cost at one Walgreens pharmacy. February 27, 2009.
Download: U.S. English
For decades, the drug of choice for oral treatment of streptococcal pharyngitis in adolescents and adults has been penicillin V 250 mg taken three or four times a day.1 Amoxicillin is equally effective, but penicillin is generally recommended because of its narrower spectrum. In adults, immediate-release amoxicillin is usually dosed 375-500 mg two to three times a day, but giving it in a higher dose (750-1000 mg) once a day appears to be equally effective for treatment of strep throat.2-4
Each Moxatag tablet contains 775 mg of amoxicillin divided into one immediate-release and two delayedrelease components. Compared to a similar dose of immediate-release amoxicillin suspension, absorption of amoxicillin from the new formulation is slower, resulting in a lower peak serum concentration, but the elimination half-life and amoxicillin exposure (AUC) are similar. S. pyogenes is susceptible to these serum concentrations, but they may be too low to treat other types of infections.
A 10-day supply of Moxatag is expected to cost about $100 compared to $4 for a similar course of penicillin V or immediate-release amoxicillin.5 There is no good reason to prescribe Moxatag.
1. A Bisno et al. Practice guidelines for the diagnosis and management of group A streptococcal pharyngitis. Infectious Disease Society of America. Clin Infect Dis 2002; 35:113.
2. P Shvartzman et al. Treatment of streptococcal pharyngitis with amoxycillin once a day. BMJ 1993; 306:1170.
3. HM Feder Jr. et al. Once-daily therapy for streptococcal pharyngitis with amoxicillin. Pediatrics 1999; 103:47.
4. HW Clegg et al. Treatment of streptococcal pharyngitis with once-daily compared with twice-daily amoxicillin: a noninferiority trial. Pediatr Infect Dis J 2006; 25:761.
5. Retail cost at one Walgreens pharmacy. February 27, 2009.
Download: U.S. English
Antimicrobial Prophylaxis for Surgery
The Medical Letter on Drugs and Therapeutics • December 1, 2006; (Issue 52)
Antimicrobial prophylaxis can decrease the incidence of infection, particularly surgical site infection, after certain procedures. Recommendations for prevention of surgical site infection are listed in this...
Antimicrobial prophylaxis can decrease the incidence of infection, particularly surgical site infection, after certain procedures. Recommendations for prevention of surgical site infection are listed in this article.
Oral Contraceptives
The Medical Letter on Drugs and Therapeutics • May 15, 2000; (Issue 1078)
Two types of oral contraceptives are available in the USA: combination oral contraceptives that contain both an estrogen and a progestin, and progestin-only contraceptives, or "mini-pills."Used as directed, all...
Two types of oral contraceptives are available in the USA: combination oral contraceptives that contain both an estrogen and a progestin, and progestin-only contraceptives, or "mini-pills."Used as directed, all oral contraceptives marketed in the USA are similarly effective in preventing pregnancy.
Treatment of Lyme Disease
The Medical Letter on Drugs and Therapeutics • May 1, 2000; (Issue 1077)
Lyme disease is caused by the spirochete Borrelia burgdorferi and transmitted to humans by Ixodes ticks. These ticks may also carry other pathogens; co-transmission of Babesia and Ehrlichia species has been...
Lyme disease is caused by the spirochete Borrelia burgdorferi and transmitted to humans by Ixodes ticks. These ticks may also carry other pathogens; co-transmission of Babesia and Ehrlichia species has been reported.
Cefdinir--A New Oral Cephalosporin
The Medical Letter on Drugs and Therapeutics • August 28, 1998; (Issue 1034)
Cefdinir (Omnicef - Parke-Davis), a third-generation oral cephalosporin, has been approved by the FDA for treatment of acute sinusitis, otitis media, acute exacerbations of chronic bronchitis, pharyngitis,...
Cefdinir (Omnicef - Parke-Davis), a third-generation oral cephalosporin, has been approved by the FDA for treatment of acute sinusitis, otitis media, acute exacerbations of chronic bronchitis, pharyngitis, community-acquired pneumonia and skin infections. Other drugs available for these indications are reviewed in The Medical Letter Handbook of Antimicrobial Therapy, 1998.
Anthrax Vaccine
The Medical Letter on Drugs and Therapeutics • May 8, 1998; (Issue 1026)
Now that US Secretary of Defense has decided to vaccinate more than 2 million memebers of the US armed forces against anthrax, US physicians may be asked to answer some questions about the vaccine and the...
Now that US Secretary of Defense has decided to vaccinate more than 2 million memebers of the US armed forces against anthrax, US physicians may be asked to answer some questions about the vaccine and the disease.
Drugs for AIDS and Associated infections
The Medical Letter on Drugs and Therapeutics • September 3, 1993; (Issue 904)
Results of recently completed clinical trials have led to some changes in recommendations for treatment of human immunodeficiency virus (HIV) and other infections associted with...
Results of recently completed clinical trials have led to some changes in recommendations for treatment of human immunodeficiency virus (HIV) and other infections associted with AIDS.
Drugs For AIDS And Associated Infections
The Medical Letter on Drugs and Therapeutics • October 18, 1991; (Issue 855)
A growing number of clinical trials now permits some consensus on the treatment of human immunodeficiency virus (HIV) and other infections associated with acquired immune deficiency syndrome (AIDS) in...
A growing number of clinical trials now permits some consensus on the treatment of human immunodeficiency virus (HIV) and other infections associated with acquired immune deficiency syndrome (AIDS) in adults.
Ofloxacin
The Medical Letter on Drugs and Therapeutics • July 26, 1991; (Issue 849)
Ofloxacin (Floxin - McNeil, Ortho), a new fluoroquinolone antibacterial agent, was recently marketed in the USA for oral treatment of various infections caused by susceptible microorganisms. Ofloxacin is the...
Ofloxacin (Floxin - McNeil, Ortho), a new fluoroquinolone antibacterial agent, was recently marketed in the USA for oral treatment of various infections caused by susceptible microorganisms. Ofloxacin is the third fluoroquinolone to become available in this country. Norfloxacin (Noroxin - Medical Letter, 29:25, 1987) is marketed only for treatment of urinary tract infections. Ciprofloxacin (Cipro - Medical Letter, 30:11, 1988), like ofloxacin, is approved for use in a variety of infections.
Penicillin Allergy
The Medical Letter on Drugs and Therapeutics • August 12, 1988; (Issue 772)
A penicillin is the drug of choice for treatment of many infections, but allergic reactions to these drugs occur frequently and, rarely, can be fatal. From 5% to 20% of patients have a history of a rash or...
A penicillin is the drug of choice for treatment of many infections, but allergic reactions to these drugs occur frequently and, rarely, can be fatal. From 5% to 20% of patients have a history of a rash or some other reaction while taking a penicillin, but maculopapular rashes with ampicillin or amoxicillin, especially in children with infectious mononucleosis, are probably not allergic.