Essential Antibiotic Dosages for Thai Medical Practice

Dose ยา

• Acetylcysteine (Fluimacil) (200): 1x3 po pc
• Air-x (80): 1x3 po pc
• Aldactone (100): 1x1 po pc for cirrhosis
• Aldosterone (Aldactone) (25): 1x2 1x3 po pc
• Allopurinol (100) (300): Start 50-100 mg, increase by 50-100 mg every 1-4 weeks until uric acid level decreases (adjust for renal function). !!! Advice: SJS risk
• Amitryptyline (10): 1x2 po hs
• Antivenom Hematotoxin: 3 vials + NSS 100 ml IV drip over 1 hr. Start with 3 vials. F/U VCT q 6 hr. If VCT > 20, give 5 more vials. If anaphylaxis occurs, administer Adrenaline 0.1-0.3 mg diluted in NSS 10-20 ml IV push, avoid IM administration. F/U VCT at 0, 2, 6, 24, 48, and 72 hr. Administer dT, and give Augmentin.
• Antivenom Neurotoxin: 5 vials + NSS 100 ml IV drip over 1 hr. Start with 5 vials. If no improvement, give 10 more vials.
• Baclofen (10): 1x3 po pc
• Betahistine (12, 24): 1x3 po pc
• Buscopan: 20 mg IV q 6-8 hr
• Captopril (25): 1 tab po, may add Amlo (10) 1 tab po for HT urgency
• Carvedilol (6.25): 1x2 po pc
• Codeine (Ropect = Codeine 10 + Guaifenesin 100) (Codepect) (10): 1x3 po pc
• CPM 10 mg (1 amp): IV/IM q 4-6 hr
• CPM 10 mg: IV/IM before blood transfusion
• CPM (4): 1x3 po pc
• Cyproheptadine: 1x3 po ac for appetite stimulation (S/E: cognitive impairment, caution in elderly)
• Daflon: 2x3 po x 4 days, then 2x2 po for 3 days, then 1x2 po for 1 week to 1 month
• Dexamethasone 8 mg: IV stat for COPD with AE or asthma attack, then Prednisolone (5) 2x3 po pc x 5 days
• Dexamethasone 5 mg: IV q 6 hr (high dose: 0.5-1 MKD) for COPD with AE, anaphylaxis, or active SLE, no taper, then switch to prednisolone
• Dextromethorphan (15): 1x4 po pc
• Diazepam (Valium) 10 mg: IV stat
• Dicyclomine (10): 2x3 po pc for abdominal cramps, alternative to Buscopan
• Dimenhydrinate (50): 1 tab po prn q 8 hr
• Dimenhydrinate 50 mg (1 amp): IV/IM stat q 8 hr
• Domperidone (Motilium) (10): 1x3 po ac 30 min
• Domperidone (10): 2x3 po pc for lactation
• Doxazocin (2, 4): 1x1 1x2 po hs (dose 2-4 mg/day), caution for postural hypotension. For patients with AUR, consider doxazocin + Foley, follow up in 1 week with uro for off Foley trial
• Douzabox (Vit B1 6 12): 1x3 po pc

STEMI

1. Fibrinolytic candidate

• Enoxaparin:
• Age < 75: 30 mg IV then 1 mg/kg SC q 12 hr (SC given 15 min after IV; first 2 SC doses combined not to exceed 100 mg)
• Age ≥ 75: 0.75 mg/kg q 12 hr (first 2 SC doses combined not to exceed 75 mg)
• ASA: Load 162-325 mg then 81-100 mg/day
• Clopidogrel:
• Age ≥ 75: Load 300 mg then 75 mg/day
• Age < 75: 75 mg/day (no load)

1. PCI candidate

• ASA: Load 162-325 mg then 81-100 mg/day
• Clopidogrel: Load 600 mg then 75 mg/day
• Ticagrelor (preferred): Load 180 mg then 90 mg bid
• Prasugrel: Load 60 mg then 10 mg/day

NSTEMI

• Enoxaparin: 0.3 ml (0.5 mg/kg) IV stat, then SC next 15 min for STEMI with fibrinolytics (e.g., SK) given within 24 hr of SK; if > 75 yr, skip IV and give SC directly
• Enoxaparin: 0.01 ml/kg (1 mg/kg, >75 yr 0.75 mg/kg) (1 amp = 0.6) SC q 12 hr x 3-5 days for NSTEMI/PE; if GFR < 30, give OD; avoid if GFR < 15
• Enoxaparin: 0.015 ml/kg/day (1.5 mg/kg/day) OD or divided q 12 hr x 3 days for bridging/starting warfarin
• Ferrous fumarate (200): 1x1 1x3 po pc
• Finasteride (5): 1x1 po pc
• Fluimacil (200): 1×3 po pc
• Fluimacil (600): 1x1 po pc
• Folic acid (5): 1x1 po pc
• Fondaparinux 2.5 mg: SC OD, avoid if GFR < 30
• 10% Glyceol: 500 mg IV q 12 hr
• 50% Glucose: 50 ml IV push, then DTX next 1 hr
• GG (Glyceryl Guaiacolate) (100): 1x3 2x3 po pc
• Haloperidol (5): 1x1 po hs
• Haloperidol: 2-5 mg IM prn agitation q 1 hr, max 20 mg/day
• Heparin: Load 80 u/kg, then drip 18 u/kg/hr for acute limb ischemia, PE, then F/U APTT ratio q 6 hr, keep 1.5-2.0
• Heparin: Load 60 u/kg, then drip 12 u/kg/hr for NSTEMI, then F/U APTT ratio q 6 hr, keep 1.5-2.0
• Heparin: 5000 u IV push then Heparin 10,000 u + NSS 100 ml (100:1) IV 5-10 ml/hr, then F/U APTT ratio q 6 hr, keep APTT ratio 1.5-2.0 (increase by 0.5-1.0)
• Hydrocortisone 100 mg: IV before blood transfusion
• Hydrocortisone 200 mg: IV q 6 hr for anaphylaxis
• Hydroxychloroquine: 5 MKD for SLE
• Hydroxyzine (Atarax) (10): 1x2 1x3 po pc (causes drowsiness)
• Isordil (ISDN) (5): 1 tab SL prn angina q 15 min, max 3 doses (S/E: headache)
• If improved after 1 tab, take another in 3-5 minutes if needed. If not improved after 1 tab, take another and seek medical attention.
• Equivalent dose: ISDN 1 tab = NTG drip 80 mcg/min
• Isordil (ISDN) (10): 1x3 po ac
• ISMO (10): 1x1 po pc
• Lactulose 30 ml: po hs, q 4 hr, keep bowel movements 3 times/day for HE, hold if > 3
• Lasix: 20-40-80-160-250 mg IV q 4-6-8-12 hr, response based on dose (Cr x 20; e.g., Cr 1 = 20, Cr 1.2 = 24, Cr 1.5 = 30, Cr 1.7 = 34), step up as needed
• Lasix (40): 1x1 po pc (BUN × 2 or Cr × 20)
• Lasix: 250 mg IV drip over 6 hr
• Lasix: 1 gm IV drip over 24 hr
• Lasix: Max 250 mg/dose, 1 gm/day, rate max 4 mg/min (slow injection); ototoxic
• Lasix: Switch from IV to oral dose = IV dose x 2 mg/day, give large dose (e.g., 2x1 more effective than 1x2)
• Lasix: Switch from oral to IV dose = daily dose x 2.5 mg/dose
• Lasix: Assess at 2 hr, if UO not achieved, double dose
• Lasix: If high dose unresponsive, add HCTZ 25-50 mg po before Lasix by 4 hr for sequential blockade
• Levetiracetam (Keppra) 1000 mg: IV load, then 500 mg IV q 12 hr for traumatic seizure
• Levetiracetam (Keppra) (500): 2x2 po pc
• Loratadine: 1x2 po pc
• Lorazepam (1): 1 tab po hs
• Lugol's solution: 3-10 drops po/SL/RS q 6-12 hr for thyroid storm, give 1 hr after PTU
• 50% MgSO4 2 gm (4 ml): + NSS 100 ml IV drip over 30 min for severe asthma (if 3 doses of inhalation not effective)
• Methylprednisolone 40 mg: IV q 12 hr for extubation preparation
• Methylprednisolone: 30 mg/kg IV bolus over 15 min, then IV drip 5.4 mg/kg/hr for 23 hr, within 8 hr for spinal cord injury
• Metoclopramide (Plasil) 10 mg: IV/IM q 6-8 hr
• Metoprolol (100): 1/4 x 2 po pc for palpitation
• Midazolam (Dormicum) 5 mg: IV stat
• Mixtard: Start at 0.1-0.2 u/kg, given morning and evening, adjust by 2 u/meal
• MOM: 30 ml po hs
• Motilium (10): 1x3 po ac
• Mucilin (Psyllium): 1x3 po pc
• NSS: Up to 4 ml NB q 4 hr with secretion suction
• Neurobion (Vit B1 6 12): 1x3 po pc
• Octreotide 250 mcg: + NSS 50 ml IV drip at 5 ml/hr (water excess caution)
• Octreotide 50 mcg: IV bolus, then IV drip 25-50 mcg/hr
• Octreotide 50 mcg: IV bolus, then 250 mcg + NSS 250 ml (1:1) IV drip 50 ml/hr (50 mcg/hr)
• Omeprazole (Losec) (20): 1x1 po ac for general use, follow-up in 2 weeks, if improved, continue for 4-6 weeks then off
• Omeprazole: 1x2 po ac for GERD, continue for 6-8 weeks
• Omeprazole 40 mg: IV OD for stress conditions (e.g., ETT, sepsis)
• Omeprazole 80 mg: IV load, then 40 mg IV q 12 hr for UGIH
• Ondansetron (Onsia) 4: (post-op) - 6-8 (chemo) mg IV q 6-8 hr
• Ondansetron (Onsia) 4 mg: IV/IM for N/V, very effective with no EPS
• Onsia (4): 1 tab po prn q 6-8 hr
• Oseltamivir (75): 1x2 po pc x 5 days
• Pantoprazole 80 mg: IV load, then 80 mg + NSS 100 ml IV drip at 10 ml/hr (load 80 drip 8)
• Pantoprazole 40 mg: IV OD or q 12 hr
• Paracetamol (250): 1-2 tab RS
• Paracetamol 300 mg: IM if NPO
• Phenytoin (Dilantin) 100 mg: IV q 8 hr
• Phenytoin (Dilantin) 1000 mg: (15-20 mg/kg) + NSS 100 ml IV drip over 30 min (loading, dose 15-20 mg/kg), then Dilantin 100 mg IV q 8 hr for 7 days (dose 5 mg/kg/day)
• Phenytoin (Dilantin) (100): 3x1 po hs
• Phenytoin (Dilantin) (50): 2x3 po pc ช ย ก่อนนอน
• Phenytoin: Do not mix in IV dextrose solutions
• Prednisolone (5): 2x3 po pc
• Prednisolone (5): 4x2 po pc x 5 days in asthma
• Prednisolone (5): 1-0-0 or 1-0-0.5 (5-7.5 mg/kg) for tail hydro from CIRCI
• Prednisolone (5): 2-0-1 tab for AI stress dose, taper to 1-0-1, 1-0-0.5, 1-0-0
• Prednisolone: 30-40 mg/day x 5 days for COPD with AE (+Omeprazole if > 65 yr)
• Prevacid (Lanzoprazole) (30): 1x1 po ac
• Proctosedyl: 1 tab RS hs x 7 days
• Propranolol (10): 1x2 po pc
• Propranolol (40): 1 tab po prn q 6-8 hr
• PTU: 500-1000 mg po loading, then 250 mg po q 4 hr for thyroid storm, avoid in liver failure
• PTU: 600 mg + sterile water 90 ml retention enema, then 250 mg q 4 hr for thyroid storm when oral not possible (e.g., bowel perforation)
• Ranitidine 80 mg: IV stat, then IV drip 8 mg/hr for UGIH
• Ranitidine 50 mg: IV q 8 hr
• Ranitidine (150): 1x2 1x3 po pc
• RI: 0.14 u/kg IV/IM stat, then RI (1:1) IV rate 0.14 u/kg/hr, DTX q 1 hr, VBG q 2-4 hr, electrolytes q 4 hr; if out, start RI-NPH/mixtard 20-0-10 (0.5-0.8 u/kg/day or previous dose, last 6 hr dose x 4) before off RI IV 30-60 min, split 50% basal (2/3 morning-1/3 evening), 50% bolus for PP
• rt-PA: ... mg for PE arrest
• rt-PA: For PE 0.6 mg/kg IV drip over 15 min or 10% push + 90% drip over 1 hr
• rt-PA: 0.9 mg/kg (max 90 mg) for ischemic stroke, 10% IV push over 1 min, then 90% IV drip over 1 hr
• Sandostatin (Octreotide) 200 mcg: + NSS 200 ml (1:1) IV load 50 ml stat (50 mcg bolus), then IV drip 50 ml/hr (50 mcg/hr)
• Senokot: 2 tabs po hs
• Smecta: 1x3 po pc
• Spironolactone: For reducing ascites in liver failure
• SSKI: 1-5 drops q 6-12 hr po/SL/RS for thyroid storm, give 1 hr after PTU
• Streptokinase: 1.5 mu IV drip over 60-90 min, repeat EKG at 60 min, should decrease by 50%
• Sucralfate: 1 gm 1x3 po ac
• Sucralfate: 50 ml + NSS 500 ml irrigate NG bid, clamp 30 min after irrigate
• Sulprostone (Nalador) 500 mcg: + sterile water 250 ml IV drip over 30 min
• Theophylline SR (200): 1x1 1x2 po pc
• Thiamine 100 mg: IV/IM OD x 3 days for alcohol withdrawal, may mix with NSS IV drip, then switch to Vit B1 ± Vit B6 orally
• Thiamine 500 mg: IV q 8 hr for septic shock with liver failure not resolving lactate (do not give in the early phase)
• Transamin 250 mg: IV q 6 hr (medication)
• Transamin 500-1000 mg: IV q 6-8 hr (500 q 6) dilute with up to 10 ml, push over 10 min; if bleeding persists, repeat in 30 min, then 24 hr interval
• Transamine 1 gm: IV q 8 hr for trauma
• Transamine (250): 1x3 po pc
• Valproate (Depakin) 500 mg: + NSS 100 ml IV drip over 20 min
• Vit B1 (100): 1x2 po pc
• Vit B12 (100): 1x1 po pc
• Vit B co: 1 amp IV OD
• Vit B co: 2 ml add in IV
• Vit C (100): 1x3 po pc
• Vit D3 (medi-alpha): 1x1 po pc
• Vit K 10 mg: IV OD high dose for major bleeding
• Vit K low dose: 1-5 mg po or IV for non-major bleeding
• Vit K 30 mg: IV stat for trauma with coagulopathy
• MTV (20): 1x2 po pc
• Tolvaptan (15): 1/2 tab po pc
• Trazodone (50): 1x1 po hs ?
• Unison enema 100 ml: RS stat/hs
• Warfarin (3): 1x2 po x 3 days loading for starting warfarin/bridging, then adjust based on PT/INR, taper to (2, 3) 1 tab po
• Xylocaine viscous: Rinse mouth bid Antibiotics

Amoxicillin (250-500 mg): 1x3 po pc, typically for 7-10 days

1. Amoxicillin/Clavulanate (Augmentin) (500/125 mg): 1x3 po pc, typically for 7-10 days
2. Cephalexin (250-500 mg): 1x4 po pc, typically for 7-14 days
3. Ciprofloxacin (500 mg): 1x2 po pc, typically for 7-14 days
4. Doxycycline (100 mg): 1x2 po pc first day, then 1x1 po pc, typically for 7-14 days
5. Erythromycin (250-500 mg): 1x4 po pc, typically for 7-10 days
6. Levofloxacin (500 mg): 1x1 po/IV pc, typically for 7-14 days
7. Metronidazole (500 mg): 1x3 po/IV pc, typically for 7-10 days
8. Clindamycin (300 mg): 1x3 po pc or 600 mg IV q 8 hr, typically for 7-10 days
9. Azithromycin (500 mg): 1x1 po pc for 1 day, then 250 mg 1x1 po pc x 4 days, typically for 5 days total
10. Acyclovir (400 mg): 1x3 po pc for herpes genitalis, typically for 7-10 days
11. Trimethoprim/Sulfamethoxazole (Bactrim, Cotrimoxazole) (160/800 mg): 1x2 po pc, typically for 7-14 days

Additional Common Antibiotics

1. Gentamicin:

• Gentamicin (3-5 mg/kg/day): 1x1 IV, typically for 7-10 days
• Gentamicin (1-2 mg/kg/dose): 1x3 IV for severe infections, typically for 7-10 days

1. Meropenem:

• Meropenem (500 mg - 1 g): 1x3 IV q 8 hr, typically for 7-14 days

1. Vancomycin:

• Vancomycin (15-20 mg/kg): 1x2 IV, adjust dose based on serum trough levels, typically for 7-14 days
• Vancomycin (125-250 mg): 1x4 po for Clostridioides difficile infection, typically for 10-14 days

1. Colistin:

• Colistin (2.5-5 mg/kg/day): 1x3 IV, divided doses based on renal function, typically for 7-14 days
• Colistin (loading dose 300 mg): 1x1 IV, then maintenance dose adjusted by renal function, typically for 7-14 days

1. Ceftriaxone:

• Ceftriaxone (1-2 g): 1x1 IV/IM, typically for 7-14 days

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