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Questions and Answers
A 45-year-old male with mild leptospirosis is prescribed an antibiotic. He reports difficulty swallowing pills. Which of the following oral antibiotics would be most appropriate as a step-down therapy option?
A 45-year-old male with mild leptospirosis is prescribed an antibiotic. He reports difficulty swallowing pills. Which of the following oral antibiotics would be most appropriate as a step-down therapy option?
- Intravenous Ampicillin
- Ceftriaxone
- Intravenous Penicillin G
- Doxycycline (correct)
A child is diagnosed with mild leptospirosis. Which of the following antibiotic regimens is the most appropriate first-line treatment?
A child is diagnosed with mild leptospirosis. Which of the following antibiotic regimens is the most appropriate first-line treatment?
- Aqueous penicillin G 6-8 million U/m²/day in 6 divided doses for 1 week
- Doxycycline 100 mg BID PO for 10 days
- Amoxicillin 30-50 mg/kg/day in 3 divided doses, maximum of 2 grams per day (correct)
- Azithromycin 500 mg OD for 5 days
An adult patient is diagnosed with severe leptospirosis (Weil syndrome). What is the most appropriate primary antibiotic regimen?
An adult patient is diagnosed with severe leptospirosis (Weil syndrome). What is the most appropriate primary antibiotic regimen?
- Doxycycline 100 mg BID PO for 10 days
- Erythromycin 10 mg/kg/day orally in four divided doses for 1 week
- Penicillin G 1.5 million units IV q6 hours for 7 days (correct)
- Amoxicillin 500mg QID or 1g q8h
A 60-year-old patient with a known penicillin allergy is diagnosed with severe leptospirosis (Weil syndrome). Which of the following would be the most appropriate alternative antibiotic regimen?
A 60-year-old patient with a known penicillin allergy is diagnosed with severe leptospirosis (Weil syndrome). Which of the following would be the most appropriate alternative antibiotic regimen?
A 7-year-old child is diagnosed with severe leptospirosis. Which of the following is the most appropriate antibiotic?
A 7-year-old child is diagnosed with severe leptospirosis. Which of the following is the most appropriate antibiotic?
A 55-year-old male with normal renal function is diagnosed with mild leptospirosis. Which of the following dosages of amoxicillin is correct?
A 55-year-old male with normal renal function is diagnosed with mild leptospirosis. Which of the following dosages of amoxicillin is correct?
A 62-year-old patient with an estimated creatinine clearance of 60 ml/min is diagnosed with leptospirosis and prescribed ampicillin. What would be the appropriate dosing interval?
A 62-year-old patient with an estimated creatinine clearance of 60 ml/min is diagnosed with leptospirosis and prescribed ampicillin. What would be the appropriate dosing interval?
A 70-year-old patient with severe renal impairment (creatinine clearance < 10 ml/min) requires cefotaxime. What dosing interval is most appropriate?
A 70-year-old patient with severe renal impairment (creatinine clearance < 10 ml/min) requires cefotaxime. What dosing interval is most appropriate?
A patient with normal renal function is prescribed azithromycin dihydrate for leptospirosis. What is the recommended dosage?
A patient with normal renal function is prescribed azithromycin dihydrate for leptospirosis. What is the recommended dosage?
Which of the following antibiotics requires no dosage adjustment for patients with renal impairment, according to the provided information?
Which of the following antibiotics requires no dosage adjustment for patients with renal impairment, according to the provided information?
Flashcards
Doxycycline dosage for mild leptospirosis (adults)
Doxycycline dosage for mild leptospirosis (adults)
For mild leptospirosis in adults, 100 mg twice daily for 10 days.
Amoxicillin dosage for mild leptospirosis (children)
Amoxicillin dosage for mild leptospirosis (children)
Amoxicillin 30-50 mg/kg/day in 3 divided doses, maximum of 2 grams per day.
Penicillin G dosage for severe leptospirosis (adults)
Penicillin G dosage for severe leptospirosis (adults)
Penicillin G 1.5 million units IV every 6 hours for 7 days.
Aqueous penicillin G dosage for severe leptospirosis (children)
Aqueous penicillin G dosage for severe leptospirosis (children)
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Amoxicillin dosage for adults with normal renal function
Amoxicillin dosage for adults with normal renal function
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Ampicillin dosage for adults with normal renal function
Ampicillin dosage for adults with normal renal function
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Cefotaxime dosage for adults with normal renal function
Cefotaxime dosage for adults with normal renal function
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Ceftriaxone dosage for adults with normal renal function
Ceftriaxone dosage for adults with normal renal function
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Doxycycline dosage for adults with normal renal function
Doxycycline dosage for adults with normal renal function
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Penicillin G dosage for adults with normal renal function
Penicillin G dosage for adults with normal renal function
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Study Notes
Mild Leptospirosis Treatment
- Adults (First Line): Doxycycline 100 mg BID PO for 10 days.
- Children (First Line): Amoxicillin 30-50 mg/kg/day in 3 divided doses, maximum 2 grams per day.
- Adults (Alternative):
- Amoxicillin 500mg QID or 1g q8h.
- Azithromycin dihydrate 1 g initially, followed by 500 mg OD for 2 more days.
- Children (Alternative): Erythromycin 10 mg/kg/day orally in four divided doses for 1 week.
Severe Leptospirosis (Weil Syndrome) Treatment
- Adults (Primary Regimen):
- Penicillin G 1.5 million units IV q 6 hrs for 7 days.
- Ceftriaxone 1gm q24h for 7 days.
- Children (Primary Regimen):
- Aqueous penicillin G 6-8 million U/m²/day in 6 divided doses for 1 week.
- Ampicillin 100 mg/kg/day IV every 6 hours.
- Adults (Alternative):
- Ampicillin 0.5-1.0 gm q6h.
- Azithromycin dihydrate 500 mg OD for 5 days.
- Cefotaxime 1 gm q6h.
- Children (Alternative):
- Tetracycline 25-50 mg/kg/day orally in four divided doses or IV tetracycline 10-20mg/kg/day IV in four divided doses, max 3 g/day, avoid in children < 9 years.
- Doxycycline 5 mg/kg/day PO in 2 divided doses (max 200mg/day) x 1 week.
- Ampicillin 100 mg/kg/day IV every 6 hours.
- Erythromycin 10 mg/kg/day orally in four divided doses for 1 week.
- Step-down therapy can be instituted once the patient is clinically stable and able to tolerate oral medication; any oral antibiotic can be selected.
Dosage of Antibiotics in Adults with Renal Impairment
- Amoxicillin normal dose is 500mg q6h or 1g q8h
- Adjustments for renal failure:
- Creatinine clearance 50-90 ml/min: Q8h
- Creatinine clearance 10-50 ml/min: Q8-12h
- Creatinine clearance <10 ml/min: Q24h
- Adjustments for renal failure:
- Ampicillin normal dose is 0.5-1gm q6h
- Adjustments for renal failure:
- Creatinine clearance 50-90 ml/min: Q6h
- Creatinine clearance 10-50 ml/min: Q6-12h
- Creatinine clearance <10 ml/min: Q12-24h
- Adjustments for renal failure:
- Azithromycin dehydrate normal dose is 500mg OD
- No dose adjustment is needed for renal failure.
- Cefotaxime normal dose is 1gm q6h
- Adjustments for renal failure:
- Creatinine clearance 50-90 ml/min: Q8-12h
- Creatinine clearance 10-50 ml/min: Q12-24h
- Creatinine clearance <10 ml/min: Q24h
- Adjustments for renal failure:
- Ceftriaxone normal dose is 1 gm q24h
- No dose adjustment is needed for renal failure.
- Doxycycline normal dose is 100mg BID
- No dose adjustment is needed for renal failure.
- Penicillin G normal dose is 1.5 MU q6h
- No dose adjustment is needed for renal failure.
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