Pediatric antibiotic recommendations

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These recommendations taken from the Montreal Children's Hospital, 2002

Contents

Otitis media and sinusitis

Non penicillin-allergic patients

  • 1st line: amoxicillin 50mg/kg/day ÷ TID
  • 2nd line: clavulin (7:1) 45mg/kg/day ÷ BID or cefzil 30mg/kg/day ÷ BID
  • 3rd line: “high dose” amoxicillin 80-100mg/kg/day ÷ TID

Penicillin-allergic patients

  • 1st line: clarythromycin 15mg/kg/day ÷ BID or azithromycin 10mg/kgday 1, 5mg/kg days 2-5
  • 2nd line: cefzil 30 mg/kg/day ÷ BID
  • 3rd line: ceftriaxone 50mg/kg/dose

Other options for Otitis Media

  • ceftriaxone 50mg/kg/dose x 1 dose IM/IV (equivalent to 10 days therapy with all 1st, 2nd, and most 3rd line agents)
  • ceftriaxone 50mg/kg/dose x 3 doses IM/IV when highly resistant pneumococcus either suspected or proven


Pneumonia

Suspected Bacterial Infection

  • 1st line: amoxicillin 50mg/kg/day ÷ TID (cefzil, clarithromycin or azithromycin if pen allergic – doses as above)
  • 2nd line: high dose amoxicillin 80-100mg/kg/day ÷ TID (ceftriaxone IM/IV if pen allergic – dose as above)

Suspected atypicals

  • e.g., mycoplasma
  • clarythromycin 15mg/kg/day ÷ BID
  • azithromycin 10mg/kg day 1, 5mg/kg days 2-5
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