Requires Infectious Disease consultation for use OR completion of the Restricted Antimicrobial order form for approved indications 100 mg IV load on day 1 then 50 mg IV every 12 hr
Severe Impairment - Child Pugh C
100 mg load on day 1 then 25 mg IV every 24 hr
Documented Allergy to Beta-lactams/vancomycin and/or resistant to other antimicrobials and one of the following criteria met:
Treatment of Intra-abdominal infection
Treatment of skin and soft tissue infection
Treatment of polymicrobial infections (not Psuedomonas or Proteus)
Pneumonia, as unacceptably high failure rates have been reported (see black box warning)
Bacteremia, as documented safety concerns exist.
Infections caused by Pseudomonas and Proteus species
Reserved for highly resistant infections or when significant allergies restrict other options and when there is documented susceptibility.
Associated with more treatment failures than alternatives and excess mortality - Black Box Warning.
Avoid or use with caution in patients with tetracycline reactions.
GI side effects very prominent with significant nausea and vomiting.
Tetracycline related adverse events: photosensitivity, acute pancreatitis.
Rash, abnormal liver enzymes.
Oral contraceptives less effective.
Requires Infectious Disease consultation.
Documented safety concerns in bacteremia especially.
Antimicrobial class: Tetracycline derivative
Pregnancy category: D
Average serum half life: 42 hours
Lung penetration: Therapeutic
Biliary penetration: Therapeutic