The Navigation Model of Therapy: Why Awareness Changes Everything
November 16, 2025
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Background
Epidemiology
Anatomy
Pathophysiology
Etiology
Genetics
Prognostic Factors
Clinical History
Physical Examination
Age group
Associated comorbidity
Associated activity
Acuity of presentation
Differential Diagnoses
Laboratory Studies
Imaging Studies
Procedures
Histologic Findings
Staging
Treatment Paradigm
by Stage
by Modality
Chemotherapy
Radiation Therapy
Surgical Interventions
Hormone Therapy
Immunotherapy
Hyperthermia
Photodynamic Therapy
Stem Cell Transplant
Targeted Therapy
Palliative Care
Medication
1 g IM or IV given every 12hrs for mild conditions
1-2 g IM or IV every 8hrs moderate to severe infections
2 g IV every 6-8hrs high dosing for infections
2 g IV every 4hrs for life-threatening infections
12 g is the maximum dose required per day
1-2 g IV or IM every 12hrs for moderate infections
2 g IV every 12hrs for Severe infections
3 g IV every 12hrs for Life-threatening infections
The maximum duration of therapy is seven days
Loading Dose: 200 mg via IV infusion for 1 hour on day 1 or 100 mg via IV infusion for 30mins two times on day 1 or 300 mg orally two times on day 1
Maintenance Dose: 100 mg via IV infusion for 30mins per day or 300 mg orally per day
the maximum duration of treatment is 7-14 days
500
mg
Tablet
Orally 
every 8 hrs
5
days
Extend the therapy duration as per vital signs
1-2 g IV or IM was given once a day or in equally divided doses 2x a day
maximum duration of therapy is 4-14 days
prolonged treatment recommends for complicated infections
At least treatment given ten days for diseases due to streptococcus
800
mg
Orally 
once a day
7 - 10
days
200
mg
Orally 
every 12 hrs
14
days
Note: It is indicated for Acute Community-Acquired Pneumonia.
Indicated for Community Acquired Bacterial Pneumonia (CABP)
150 mg IV 2 times a day for 5-7 days
or
600 mg orally 2 times a day for 5 days
500 mg oral tablet immediate release twice a day for a minimum of 5 days
The drug treats pneumonia acquired due to various bacterial infections
500 mg orally once a day, followed by 250 mg 4 times a day, on the 2nd to 5th day
600 mg oral/IV 2 times daily 10-14 days
400
mg
Tablet
Intravenous (IV)
every day
7 - 14
days
(M. pneumoniae; S. pneumoniae; C. pneumoniae; H. influenzae): 320mg orally every day for five days
(Multidrug-resistant K. pneumoniae; S. pneumoniae; M. catarrhalis): 320mg orally every day for 7 days
1-2g intramuscular or intravenous every 8 to 12 hours
Do not exceed 8g/day
Day 1: 500 mg orally in a single dosage;
Days 2–5: 250 mg orally per day
(Off Label):
Fluoroquinolone and 500 mg intravenously every 8 hours for around five days
Take 400 mg orally after every 12 hours up to 14 days.
Take 200 mg orally after every 12 hours up to 10 days
Renal Impairment
For creatinine clearance of 30 to 49 ml/minute/1.73 square meter: maximum up to 200 mg orally after every 12 hours
For creatinine clearance of <30 ml/minute/1.73/square meter: every day 200 mg orally
End-stage: dose not determined yet
600
mg
Intravenous (IV)
twice a day
5 - 14
days
Pending for FDA approval
1 to 2 grams intravenous/intramuscular given every 2 times a day
300 mg in single dose or two divided doses every day
Administer dose of 500 mg intramuscularly or intravenously every 6 hours
100 to 300 mg orally daily, as a single or two divided doses
Dose Adjustments
Dosing modifications
Renal impairment:
Dose adjustment is required in case of severe impairment
Mild-moderate- Take 400 mg two times a day for two weeks by oral route
200 mg taken orally 3 times a day for two weeks
Take oral dose as per physicians advised
Indicated for Pneumonia, Tracheobronchitis, Urinary tract infections:
Administer 500mg to 1g twice a day.
The usual dose for the treatment of pneumonia is 1 to 4 g via Intravenous or Intramuscular administration two or four times a day for up to 7 or 21 days
The duration of the treatment depends on the severity and the nature of the infections.
If the infection is severe, the dose can be increased up to 12 g per day
Dose Adjustments
Renal Dose Adjustment
In case of renal insufficiency, the usual dose of ceftizoxime depends on the CrCl. If the CrCl is below 5 mL/min, then 0.25-0.5 g a day or 0.5-1 g via IV or IM in 2 days after undergoing dialysis. Loading dose is standard in renal insufficiency, which is 0.5-1 g. 0.25 -1g twice a day if CrCl falls between 5 and 49 mL/min and 0.5 – 1.5 g thrice a day if CrCl is between 50 and 79 mL/min
500 mg is given orally once every day for two weeks
200
mg
Intravenous (IV)
once a day
200mg intravenous or oral for one day, followed by 200mg oral per day for one to two weeks.
It is indicated as prophylactic treatment of inhalation anthrax, tularemia caused by Francisella tularensis, and plague caused by Yersinia pestis
amoxicillin and clavulanate potassiumÂ
Indicated for Aspirational pneumonia
:
500 mg orally 3 times a day or 875 mg orally 2 times a day
Depending on the type and severity of the infection, therapy should be continued until the infiltrate is removed or a residual scar forms, which could take up to four months
Mild/Moderate/ Severe: A dose of 800 mg is given orally per day and the therapy needs to continue for 7days if any suspected pneumococcal pneumonia is present and if any other organism is present the therapy needs to continue till 21 days
Moreover, in the US the drug bacampicillin is no longer used and marketed
3g IV every 4 hours for 21 to 28 days, depending on the severity of the infection
600 mg oral/IV 2 times daily 10-14 days
≤7 days:
<2kg bodyweight: 30mg/kg intravenous every 12 hours
>2 kg bodyweight: 30mg/kg intravenous every 8 hours
8 to 30 days:
<1.2kg: 30mg/kg intravenous every 12 hours
1.2kg-2kg: 30mg/kg intravenous every 8 hours
>2kg: 30mg/kg intravenous every 6 hours
1 to 18 years: 30mg/kg intravenous every 6-8 hours
Indicated for mild to severe infections:
>3 months:
150mg/kg/day intravenous/intramuscular divided every 8 hours
6 months: Safety and effectiveness are not yet proven
For six months, administer 10 mg/kg orally x 1 dosage on Day 1 and then 5 mg/kg orally on Days 2–5.
Children >8 years and adolescents:
1 to 2 mg/kg per dose twice a day for 10 days
Age: 2 months-<2 years:
8
mg/kg
Intravenous (IV)
every 8 hrs
5 - 14
days
Age: ≥2 years-<18 years; wt: ≤33 kg: 12 mg/kg Intravenous (IV) every 8 hrs 5-14 days
Age: 2-18 years; wt: >33 kg: 400 mg Intravenous (IV) every 8 hrs OR 600 mg Intravenous (IV) every 8 hrs 5-14 days
Age: ≥18 years: 600 mg Intravenous (IV) every 8 hrs 5-7 days
Pending for FDA approval
Children up to 12 years: 5 to 8 mg/kg in two divided doses every day; maximum dose: 150 mg 2 times a day
for infants and Children:
Administer daily dose of 50 to 100 mg/kg intramuscularly or intravenously divided doses every 4 to 8 hours
If the child's weight falls below 2.5 kg, give 900/units/kg/day Intramuscular injection twice daily
If the weight falls above 2.5 kg, give 1000 units/kg/day Intramuscular injection twice daily
For children, administer 800-1200 units/kg/day three times a day
For 13 to 18 years old:
Take oral dose as per physicians advised
above 12 years: 500 mg is given orally once every day for two weeks
amoxicillin and clavulanate potassiumÂ
Age: < 3 months
For infants under 12 weeks:
Administer 15 mg per kilogram orally 2 times daily with 125 mg/5 mL oral suspension
Age: >3 months
For children weighing less than 40 kg:
With 125 mg/5 mL or 250 mg/5 mL oral suspension, administer orally 3 times daily at a dosage range of 6.67 to 13.33 mg per kilogram
With 200 mg/5 mL or 400 mg/5 mL oral suspension or chewable tablets, administer orally 2 times daily at a dosage range of 12.5 to 22.5 mg per kilogram
For children weighing 40 kg or more:
Immediate release tablets: Administer 500 mg orally every 8 hours or 875 mg orally 2 times daily
Extended release tablets: 2 g orally 2 times daily for 7 to 10 days in cases of community-acquired pneumonia
Pediatric Infectious Diseases Society and IDSA Recommends for infants and children above 3 months a dose of 150-200 mg per kg per day given IV or IM divided in every 6-8hrs
The maximum dose per day is 12 g
PDS and IDSA Recommends for infants and children 3 months and above, a dose of 150-200 mg per kg per day IV or IM given divided in every 6-8hrs
The total dose per day recommended is 12g
For Children 25 kg or above a dose of 50 mg per kg per day is given for every 2 equal divided doses at 12hrs
Moreover, in the US the drug bacampicillin is no longer used and marketed
90mg/kg/day every 12hr for 10days (do not exceed 4000mg/day)
Group A Streptococcus: 50-75 mg/kg/day every 12hr for 10 days; (do not exceed 4000mg/day)
H. influenza: 75-100 mg/kg/day every 8hr for 10 days; (do not exceed 4000mg/day)
Surgical prophylaxis IV:
50mg/kg before surgical incision within 60 mins; can be repeated in 2 hrs for excessive blood loss or lengthy procedure
Dose for child ≤ 7 days:
Birthweight < 2 kg: 75mg/kg IV every 12 hours
Dose for child > 7 days:
Birthweight > 2 kg: 75mg/kg IV every 6 hours or 100mg/kg IV every 8 hours
Dose for 1 month to 12 years:
< 40 kg: 100 to 300mg/kg/day IV in equally doses every 4 to 6 hours
> 40 kg: 3g IV every 4 to 6 hours
Future Trends
References
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