Neomycin  Sulfate ACTION  AND  USE.—  Neomycin  sulfate  is effective  against  certain  gram-negative  and  gram- positive   bacteria.   Normally   used   as   a   topical preparation for the treatment of skin infections, burn wounds, ulcers, and dermatoses, it may be used orally for reduction of intestinal flora prior to  surgery  involving  the  bowel  or  anus. USUAL  DOSE.—  700  mg  every  4  hours  as prescribed  by  a  physician. Gentamycin Sulfate (Garamycin) ACTION AND USE.— Gentamycin sulfate is indicated in the treatment of serious systemic in- fections of susceptible gram-negative organisms. While the patient is on gentamycin, it is necessary to  monitor  renal  and  hepatic  function  to  deter- mine if toxic levels are reached. Gentamycin is also available  as  a  topical  preparation  for  the  treat- ment  of  burns  and  infected  wounds,  and  as  an ophthalmic  preparation  for  eye  infections. USUAL DOSE.— The recommended dose for patients with serious infections and normal renal function is 3 mg/kg/day in equally divided doses. Gentamycin  is  normally  administered  intramus- cularly  but  can  be  administered  intravenously. MACROLIDES The  macrolide  antibiotics  constitute  a  large group of bacteriostatic agents that inhibit protein synthesis.  They  are  effective  against  gram-positive cocci, Neisseria,  Hemophilus,  and  mycobacteria. All are similar to penicillin in their antibacterial spectra and are often used in patients who are sen- sitive  to  penicillin. Erythromycin (Ilotycin, Erythrocin, E-Mycin) ACTION AND USE.— Because it has a bitter taste  and  is  destroyed  by  gastric  acids,  erythro- mycin is usually administered as an enteric coated tablet. Erythromycin is one of the drugs of choice when   penicillin   is   contraindicated.   It   is   also available  as  an  ophthalmic  ointment  and  as  a topical preparation for the adjunctive treatment of  acne. USUAL DOSE.— 250 mg four times daily or 500  mg  twice  daily  for  oral  preparations,  and 1 g daily by slow intravenous infusion or in four equally  divided  doses. Clindamycin  Hydrochloride  (Cleocin) ACTION   AND   USE.—   The  use  of  clin- damycin hydrochloride has often been associated with  severe  colitis  and  profuse  diarrhea;  if  this condition  occurs,  the  drug  should  be  discontinued. Clindamycin  hydrochloride  is  indicated  in  the treatment  of  susceptible  anaerobic  organisms.  A topical preparation is also available for the treat- ment  of  acne. USUAL DOSE.— 150 to 300 mg every 6 hours for  the  oral  form  and  600  to  1200  mg  per  daily in  2,  3,  or  4  equally  divided  doses  for  the  in- travenous   form. Vancomycin  Hydrochloride  (Vanocin) ACTION  AND  USE.—  Vancomycin   hydro- chloride  is  bactericidal  against  many  gram-positive bacteria. It is indicated in potentially life-threaten- ing  conditions  that  cannot  be  treated  with  less toxic   preparations. USUAL DOSE.—  500 mg every 6 hours or 1 g every  12  hours  intravenously  only;  vancomycin hydrochloride can be very irritating and painful when  administered  intramuscularly. MISCELLANEOUS   ANTIBIOTICS In addition to the previously mentioned anti- infectives, there are several other agents that are effective in the treatment of different organisms. Rifampin  (Rifadin) ACTION AND USE.— Rifampin is indicated in  the  treatment  of  pulmonary  tuberculosis;  it must be used in conjunction with at least one other antituberculosis   agent,   usually   ethambutol   or isoniazid. USUAL DOSE.— 600 mg in a single daily ad- ministration  throughout  the  course  of  the  disease. Isoniazid (INH) ACTION AND USE.— Isoniazid is indicated in the treatment of tuberculosis and as a preven- tive  therapy  for  high  risk  persons,  i.e.,  positive tuberculin skin test, family members of a person with  tuberculosis,  and  newly  infected  persons. 7-12