To the Editor.—
The Journal is to be congratulated for presenting the 18 guideline-audits for antimicrobial therapy. The Veterans Administration Ad Hoc Interdisciplinary Advisory Committee on Antimicrobial Drug Usage—Calvin M. Kunin, MD, Chairman (237:1001, 1977) outlined the purposes of the series and invited discussion. I suggest revision for two points: (1) the dosage schedule for meningococcal exposure prophylaxis (237:1134, 1977) and (2) the requirement for dosage modification of the lincosamines in renal failure (237:1003 and 1482, 1977).The recommendation of rifampin, 500 mg daily for five days, is difficult to follow since the drug is currently available in 300-mg preparations. A dose of 600 mg twice daily for two days (or once daily for five days) seems more widely recommended and applicable. The use of minocycline hydrochloride must be reconsidered in light of current evidence of vestibular toxicity. A more convenient schedule might be that presented by Finley.1Individual
Rhodes LP. Antimicrobial Therapy. JAMA. 1977;238(8):852. doi:10.1001/jama.1977.03280090016002
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