Antibiotic-dosing regimens used to treat Mycobacterium avium complex and Mycobacterium abscessus complex pulmonary disease in cystic fibrosis
| Antibiotic | Route | Dose suitable for children/adolescents | Dose suitable for adults |
|---|---|---|---|
| Amikacin* | Intravenous | Children: 15–30 mg/kg/dose once daily Adolescents: 10–15 mg/kg/dose once daily Maximum dose 1500 mg daily | 10–30 mg/kg once daily or 15 mg/kg/day in two divided doses Daily to 3× weekly dosing |
| Amikacin*†‡ | Nebulised | 250–500 mg/dose once or twice daily | 250–500 mg once or twice daily |
| Azithromycin | Oral | Children: 10–12 mg/kg/dose once daily Adolescents: adult dosing regimen Maximum dose 500 mg | 250–500 mg once daily |
| Cefoxitin | Intravenous | 50 mg/kg/dose thrice daily (maximum dose 12 g/day) | 200 mg/kg/day in three divided doses (maximum dose 12 g/day) |
| Clarithromycin | Oral | 7.5 mg/kg/dose twice daily (maximum dose 500 mg) | 500 mg twice daily§ |
| Clarithromycin | Intravenous | Not recommended | 500 mg twice daily§ |
| Clofazimine†¶ | Oral | 1–2 mg/kg/dose once daily (maximum dose 100 mg) | 50–100 mg once a day |
| Co-trimoxazole (sulfamethoxazole and trimethoprim) | Oral | 10–20 mg/kg/dose twice daily | 960 mg twice daily |
| Co-trimoxazole (sulfamethoxazole and Trimethoprim) | Intravenous | 10–20 mg/kg/dose twice daily | 1.44 g twice daily |
| Ethambutol | Oral | Infants and children: 15 mg/kg/dose once daily Adolescents: 15 mg/kg/dose once daily | 15 mg/kg once daily |
| Imipenem | Intravenous | 15–20 mg/kg/dose twice daily (maximum dose 1000 mg) | 1 g twice daily |
| Linezolid** | Oral | <12 years old: 10 mg/kg/dose thrice daily 12 years and older: 10 mg/kg/dose once or twice daily (maximum dose 600 mg) | 600 mg once or twice daily |
| Linezolid** | Intravenous | <12 years old: 10 mg/kg/dose thrice daily 12 years and older: 10 mg/kg/dose once or twice daily (maximum dose 600 mg) | 600 mg once or twice daily |
| Moxifloxacin | Oral | 7.5–10 mg/kg/dose once daily (maximum dose 400 mg daily) | 400 mg once daily |
| Minocycline | Oral | 2 mg/kg/dose once daily (maximum dose 200 mg) | 100 mg twice daily |
| Rifampin (Rifampicin) | Oral | 10–20 mg/kg/dose once daily (maximum dose 600 mg) | <50 kg 450 mg once daily >50 kg 600 mg once daily |
| Rifabutin | Oral | 5–10 mg/kg/dose once daily (maximum dose 300 mg) | 150–300 mg once daily 150 mg if patient taking strong CYP3A4 inhibitor 450–600 mg if patient taking strong CYP3A4 inducer |
| Streptomycin* | Intramuscular/intravenous | 20–40 mg/kg/dose once daily (maximum dose 1000 mg) | 15 mg/kg once daily (maximum dose 1000 mg) |
| Tigecycline†,†† | Intravenous | 8–11 years: 1.2 mg/kg/dose twice daily (maximum dose 50 mg) 12 years and older: 100 mg loading dose and then 50 mg once or twice daily | 100 mg loading dose and then 50 mg once or twice daily |
*Adjust dose according to levels. Usually, starting dose is 15 mg/kg aiming for a peak level of 20–30 µg/mL and trough levels of <5–10 micrograms/ml.
†As tolerated.
‡Mixed with normal saline.
§For individuals under 55 kg, many practitioners recommend 7.5 mg/kg twice daily.
¶Only available in the USA through an IND application to the FDA.
**Usually given with high dose (100 mg daily) pyridoxine (vitamin B6) to reduce risk of cytopaenias.
††Many practitioners recommend pre-dosing with one or more anti-emetics before dosing and/or gradual dose escalation from 25 mg daily to minimise nausea and vomiting.
IND, investigational new drug; FDA, Food and Drug Administration.