Ciprofloxacin or azithromycin for uti itis. Bacteriuria Infections with the bacteria Clostridium difficile and Staphylococcus aureus should be treated with a single dose of clarithromycin product and a subsequent dose of ceftriaxone. Other Drugs Antibiotics such as erythromycin, penicillin, or cephalosporin may be used if the infection does not respond to one or more of these options. In the United States, antimicrobial agents are licensed for use in children only with a prescription from physician. Children younger than 6 years must receive approval from a physician and meet the criteria for receiving these agents through an FDA-approved program before they can receive them. The most commonly prescribed antimicrobial agent for children <6 years of age in the United States is erythromycin (Rifaximin, Cephalosporin, Vibramycin, or Teicoplanin). Some combination antimicrobial agents are sometimes used in the United States but are not approved for use by the FDA. Rifaximin is administered orally (by mouth) in tablet or capsule form and is usually given to children 1–2 days per week. It is available in oral form the United States and is available in 2% or 5% dosage forms. Doses of 1 gram are recommended. Oral erythromycin should be administered for 2 weeks followed by a single dose of an antibiotic for the remainder of child's health care facility stay. Penicillin, or cephalosporin, is administered orally in tablet, gelatin capsule, or suspension form and is usually given to children 1–2 days per week. It is available in oral form the United States and is available in 2% or 5% dosage forms. Doses of 10–30 mg/kg/day have been used. Possible interactions Drugs that impair the normal metabolism and excretion of drugs, such as drugs that slow the metabolism of ciprofloxacin or azithromycin, drugs that are metabolized by enzymes other than CYP3A4, will have a greater effect than would be expected from direct drug interaction. This product is available only by prescription. Other interactions may occur at higher or lower doses. It is not possible to predict all interactions. If any interaction is occurring, consult your health care provider. Therapeutic Interactions Erythromycin Ciprofloxacin Azithromycin Clindamycin Penicillin Drug Interactions In addition, the following drugs may decrease effect of erythromycin. Nefazodone Antibiotics The following drugs may increase effect of erythromycin. Sulfonamides HIV/AIDS Hepatic Impairment In the United States, erythromycin can be administered to patients with hepatic impairment, such as chronic hepatitis or cirrhosis. Patients who are receiving erythromycin may be at increased risk of developing bacterial resistance to this drug. Hepatic impairment may increase the potential for bacterial resistance to erythromycin. Patients with chronic hepatitis have an increased risk for developing bacterial resistance to this drug. Because the risk of bacterial resistance to erythromycin is greater in this population, erythromycin should not be recommended for this population. Pregnancy/Lactation Routine use of erythromycin during pregnancy has not been studied in humans. The drug is not expected to have toxicity during pregnancy. Interactions with other medications Drugs that are used in combination with erythromycin can increase the risk of bacterial resistance to this drug. Cephalosporin Cephalosporins are widely used for the treatment of infections caused by certain strains of Staphylococcus aureus. These antibiotics are often used in combination with erythromycin to treat infection of the urinary tract. Drugs that impair the normal metabolism of cephalosporin medications, such as antibiotics cefuroxime axetil, cefoxitin, and cefpodoxime, will have a greater effect than would be expected from drug interactions. Cefuroxime axetil is a sulfonamide antibiotics used for the treatment of infections caused by certain strains of Staphylococcus aureus. Cefuroxime axetil is also used in combination with erythromycin for the treatment of urinary tract infections. While cefuroxime axetil enhances the therapeutic effect of erythromycin.
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