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TELITHROMYCIN Usual Dose Adult: 800 mg Q24H PO (UWHC cost/day $9.26) Indications 1.Community-acquired pneumonia of mild-to-moderate severity caused by proven or highly suspected multidrug-resistant S pneumoniae Comments Telithromycin may only be used where penicillin or macrolide-resistant pneumococci are suspected as infectious agents. Drug Interactions Telithromycin inhibits the CYP450 3A4 enzyme, causing many drug-drug interactions with other drugs that are metabolized by that enzyme system. The use of telithromycin is contraindicated in patients taking pimozide or cisapride. Serum levels of statin drugs, digoxin, theophylline and alprazolam may become elevated with concomitant use of telithromycin. Itraconazole and ketoconazole increase serum levels of telithromycin. Concomitant administration of rifampin significantly decreases serum levels of telithromycin. Several cases of severe liver toxicity have been reported in patients taking telithromycin, which led the FDA to retract all but one indication for use in 2007. TENOFOVIR Also a component of the combination product TruvadaÂ®. For up-to-date information on the use of antiretrovirals, consult an HIV expert or www.aidsinfo.nih.gov/ TENOFOVIR/EMTRICITABINE (TruvadaÂ®) â non-formulary at UWHC For up-to-date information on the use of antiretrovirals, consult an HIV expert or www.aidsinfo.nih.gov/ Please verify the indication for use; continuation of pre-exposure prophylaxis for inpatients may not be appropriate. TETRACYCLINE Usual Dose Adult: 250-500 mg Q6H PO OR 500 mg Q12H PO (UWHC cost/day $0.10-0.21). Pediatric:** 25-50 mg/kg/day PO in divided doses Q6H (not for children <8 years). Indications 1. Mycoplasma pneumoniae or Chlamydia pneumoniae atypical pneumonia â alternative to erythromycin and doxycycline 2. Chlamydia trachomatis infections, uncomplicated, in adults. 3. Brucellosis and bartonellosis â drug of choice 4. Rickettsial infections (e.g. Rocky Mountain spotted fever, Q fever). 5. Prophylaxis and treatment of chronic bronchitis acute exacerbations as an alternative to doxycycline. 6. Lyme disease in adults and children 8 years or older. 7. Alternative to mefloquine for malaria chemoprophylaxis in areas where chloroquine-resistant Plasmodium falciparum is prevalent. Tetracycline and doxycycline are the only available drugs for drug-resistant malaria in Thailand because mefloquine resistance has been found. 8. Plague and tularemia. Alternative to streptomycin for treatment. May be used for prophylaxis in selected patients. 9. Balantidium coli infections - drug of choice. 10. Inflammatory acne â alternative to oral erythromycin or oral doxycycline. 11. H pylori infection â alternative to amoxicillin or doxycycline. 12. Ehrlichiosis - alternative to doxycycline. Comments Tetracycline can cause discoloration of the permanent teeth and should not be used during the last half of pregnancy, nor in children < 8 years old. Drug Interactions ; Dairy products and antacids will impair the absorption of tetracycline if they are taken less than 2 hours apart. Tetracycline in combination with warfarin causes increased anticoagulation.