Not recommended fixed-dose antibiotic combinations in low- and middle-income countries – the example of Tanzania

Table 4 Characteristics of the individual ingredients of penicillin combinations in Tanzania

Ingredient	Recommended use¹	Active but Not Recommended¹	Standard dosage²
flucloxacillin or cloxacillin	S. aureus (methicillin susceptible) Susceptible coagulase negative staphylococci (CNS)	Streptococcus pyogenes (A), Streptococcus agalactiae (B) Streptococci group C,F,G, Streptococcus anginosus Streptococcus pneumoniae	Oral flucloxacillin: 1 gram, 8 hourly Oral cloxacillin: 500 mg, 6 hourly
ampicillin or amoxicillin	Actinomyces, Susceptible E. faecalis L. monocytogenes N. meningitidis P. multocida Peptostreptococci	Streptococcus pyogenes (A), Streptococcus agalactiae (B) Streptococci group C,F,G, Streptococcus anginosus Streptococcus pneumoniae Clostridium among others	Oral amoxicillin: 500 mg, 8 hourly Oral ampicillin: 250–500 mg, 6 hourly¹ (amoxicillin has increased oral absorption compared to ampicillin due to added hydroxyl group¹)

¹ Spectrum of activity and recommended use is based the Sanford Guide [68]
² Standard dosage is based on the EUCAST clinical breakpoints and dosing Table (25), except for oral ampicillin which is not listed in EUCAST.

ISSN: 2047-2994