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Uses: -Treatment of mild community acquired pneumonia due to Chlamydophila pneumoniae, Haemophilus influenzae, Mycoplasma pneumoniae, or Streptococcus pneumoniae in patients appropriate for oral therapy -Treatment of community-acquired pneumonia due to C pneumoniae, H influenzae, Legionella pneumophila, Moraxella catarrhalis, M pneumoniae, or S pneumoniae in patients who require initial IV therapy Community-acquired pneumonia: Oral: -Immediate-release: 500 mg orally as a single dose on day 1, followed by 250 mg orally once a day on days 2 to 5 -Extended-release: 2 g orally once as a single dose Parenteral: 500 mg IV once a day as a single dose for at least 2 days, followed by 500 mg (immediate-release formulation) orally to complete a 7- to 10-day course of therapy Comment: Extended-release formulations should be taken on an empty stomach. Uses: -Treatment of mild community acquired pneumonia due to Chlamydophila pneumoniae, Haemophilus influenzae, Mycoplasma pneumoniae, or Streptococcus pneumoniae in patients appropriate for oral therapy -Treatment of community-acquired pneumonia due to C pneumoniae, H influenzae, Legionella pneumophila, Moraxella catarrhalis, M pneumoniae, or S pneumoniae in patients who require initial IV therapy Community-acquired pneumonia: Oral: -Immediate-release: 500 mg orally as a single dose on day 1, followed by 250 mg orally once a day on days 2 to 5 -Extended-release: 2 g orally once as a single dose Parenteral: 500 mg IV once a day as a single dose for at least 2 days, followed by 500 mg (immediate-release formulation) orally to complete a 7- to 10-day course of therapy Comment: Extended-release formulations should be taken on an empty stomach. Uses: -Treatment of mild community acquired pneumonia due to Chlamydophila pneumoniae, Haemophilus influenzae, Mycoplasma pneumoniae, or Streptococcus pneumoniae in patients appropriate for oral therapy -Treatment of community-acquired pneumonia due to C pneumoniae, H influenzae, Legionella pneumophila, Moraxella catarrhalis, M pneumoniae, or S pneumoniae in patients who require initial IV therapy Immediate-release: 500 mg orally as a single dose on day 1, followed by 250 mg orally once a day on days 2 to 5 Use: Treatment of pharyngitis/tonsillitis caused by Streptococcus pyogenes as an alternative to first-line therapy in patients who cannot use first-line therapy IDSA Recommendations: Immediate-release: Individuals with penicillin allergy: 12 mg/kg orally once a day -Maximum dose: 500 mg/day -Duration of therapy: 5 days Use: Treatment of Group A streptococcal pharyngitis Immediate-release: 500 mg orally once a day for 3 days Extended-release: 2 g orally once as a single dose Comment: Extended-release formulations should be taken on an empty stomach. Use: Treatment of mild to moderate acute bacterial sinusitis due to H influenzae, M catarrhalis, or S pneumoniae Immediate-release: 500 mg orally as a single dose on day 1, followed by 250 mg orally once a day on days 2 to 5 Use: Treatment of mild to moderate uncomplicated skin and skin structure infections due to Staphylococcus aureus, Streptococcus pyogenes, or Streptococcus agalactiae IDSA and NIH Recommendations: Immediate-release: Patients greater than 45 kg: 500 mg orally on day 1, then 250 mg orally once a day on days 2 through 5 Patients less than 45 kg: 10 mg/kg orally on day 1, then 5 mg/kg orally once a day for 4 additional days Alternative therapy for Bartonella infections (not endocarditis or central nervous system infections): 500 mg orally once a day for at least 3 months Uses: -Treatment of bacillary angiomatosis and cat scratch disease -Alternative therapy for Bartonella infections Gonococcal urethritis and cervicitis: Immediate-release: 2 g orally once Use: Treatment of mild to moderate urethritis and cervicitis due to Neisseria gonorrhoeae US Centers for Disease Control and Prevention (CDC) Recommendations: Immediate-release: -Recommended regimen: 1 g orally once as a single dose plus ceftriaxone -Alternative regimen: 1 g orally once as a single dose plus cefixime Comments: -The alternative regimen may be used for uncomplicated infections if ceftriaxone is unavailable. -Arthritis and arthritis-dermatitis syndrome may be treated with 1 g orally once plus cefotaxime OR ceftizoxime. 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