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Rch-antibiotic-recommendations

Infection
Initial antibiotics ( ) = maximum dose
CENTRAL NERVOUS SYSTEM / EYE
Encephalitis
SA (m2) ht (cm) x wt (kg)
Meningitis
add Benzylpenicillin 60 mg/kg iv 12H (wk 1 of l fe)
6-8H (wk 2-4 of life) 4H (>wk 4 of life) and Gentamicin
Meningococc prophylaxis Rifampicin 10 mg/kg (600 mg) po 12H for 2d
Orbital cellulitis
Flucloxacillin 50 mg/kg (2 g) iv 6H and
Cefotaxime 50 mg/kg (2 g) iv 6H
Periorbital cellulitis
Mild: Amoxycillin/Clavulanate (400/57 mg per 5 mL) Severe, or <5y + not Hib imm: As for orbital cellulitis above
CARDIOVASCULAR
Endocarditis prophylaxis Amoxycillin 50 mg/kg (2 g)
po 1 hr before LA, or iv with GA induction
GASTROINTEST NAL
Peritonitis
Ampicillin or Amoxycil in 50 mg/kg (2 g) iv 6H and
Gent 7.5 (6 if >10y) mg/kg (360 mg) iv daily and
Metronidazole 15 mg/kg (1 g) iv stat,
then 7.5 mg/kg (500 mg) iv 8H
Giardiasis
Metronidazole 30 mg/kg (2 g) po daily for 3d GENITOURINARY
Benzylpenicillin 60 mg/kg (2 g) iv 6H and
Gent 7.5 (6 if >10y) mg/kg (360 mg) iv daily not sick: Trimethoprim 4 mg/kg (150 mg) po 12H or
(8/40 mg per mL) 0.5 mL/kg (20 mL) po 12H UTI prophylaxis
Trimethoprim or Co-trimoxazole
at half treatment doses above, once daily
RESP RATORY
Tonsillitis
Consider no antibiotics (particularly if <4y) or
Penicillin V 250 (500 if >10y) mg po 12H for 10d
Otitis media
Consider no antibiotics for 48 hrs (if >2y) or
Amoxycillin 15 mg/kg (500 mg) po 8H
Pertussis
Erythromycin 12.5 mg/kg (500 mg) po 6H for 14d or
Clarithromycin 7.5 mg/kg (500 mg) po 12H for 7d Pneumonia
Mild: Amoxycillin 15 mg/kg (500 mg) po 8H or
Benzylpenicillin 60 mg/kg (2 g) iv 6H and
Flucloxacillin 50 mg/kg (2 g) iv 4H and
Gent 7.5 (6 if >10y) mg/kg (360 mg) iv daily and
Consider Azithromycin* 15 mg/kg (500 mg) iv stat, then 5 mg/kg (200 mg) iv daily
SKIN / SOFT TISSUE / BONE
Adenitis
Mild: Amoxycillin/Clavulanate (400/57 mg per 5 mL) Severe: Ticarcillin/Clavulanate 50 mg/kg (3 g) iv 6H
Cellulitis
Mild: Cephalexin 25 mg/kg (500 mg) po 6H Impetigo
Mupirocin 2% ointment 8H if localised or
Cephalexin 25 mg/kg (500 mg) po 12H
Head lice
Osteomyelitis/Septic arthr Flucloxacillin 50 mg/kg (2 g) iv 4-6H
<5y + not Hib imm: add Cefotaxime 50 mg/kg (2 g) iv 6-8H
SEPTICAEMIA
Septicaemia Normal CSF: Flucloxacillin 50 mg/kg (2 g) iv 4H and
(ie sick child)
Gent 7.5 (6 if >10y) mg/kg (360 mg) iv daily Unknown CSF: Flucloxacillin 50 mg/kg (2 g) iv 4H and
replace Flucloxacillin above with
or with suspected MRSA: Vancomycin 15 mg/kg (500 mg) iv 6H

Source: http://lyris.wch.org.au:81/read/attachment/76852/1/RCH%20antibiotic%20guideline%20card.pdf

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