Table 2.2.

Plague Treatment Guidelines in Usual (Nonbioterrorism) Circumstances

Drug	Dosage	Route of administration
Streptomycina
Adults	1 g q 12 hr	IM
Children	15 mg/kg q 12 hra	IM
Gentamicinb
Adults	1–1.5 mg/kg q 8 hrc	IV or IM
Children	2.0–2.5 mg/kg q 8 hrc	IV or IM
Infants/neonates	2.5 mg/kg q 8 hrc	IV or IM
Tetracyclined
Adults	0.5 g q 6 hr	PO
Children >8 yr	6.25–12.5 mg/kg q 6 hr	PO
Doxycyclined
Adults	100 mg q 12 hr	IV or PO
Children >8 yr and >45 kg	100 mg q 12 hr	IV or PO
Children >8 yr and <45 kg	2.2 mg/kg q 12 hr	IV or PO
Chloramphenicold
Adults	12.5 mg/kg q 6 hre	IV or PO
Children > 1 yr	12.5 mg/kg q 6 hre	IV or PO

IM, intramuscularly; IV, intravenously; PO, orally.

^a Not to exceed 2 g/day.

^b Not FDA-approved for use in treating plague.

^c Daily dose should be reduced to 3 mg/kg as soon as clinically indicated.

^d An initial loading dose is usually indicated.

^e Up to 100 mg/kg/day initially. Dosage should be adjusted to maintain plasma concentrations at 5–20 μg/mL. Hematological values should be monitored closely.