By John S. Bradley MD, John D. Nelson MD Emeritus
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Additional resources for 2010-2011 Nelson's Pocket Book of Pediatric Antimicrobial Therapy
Tympanocentesis should be performed in children who Caution: up to 40% of pen-R pneumococci are also fail second-line therapy. macrolide-resistant b) For Haemophilus strains that are beta-lactamase– positive, the following oral antibiotics offer better in vitro activity than amoxicillin: amox/clav, cefdinir, cefpodoxime, cefuroxime, OR ceftriaxone IM – Newborns Otitis media, acute A note on AOM: The natural history of AOM in different age groups by specific pathogens is not well defined; therefore, the actual contribution of antibiotic therapy on resolution of disease is also poorly defined, which has lead to controversy regarding which antibiotic is best or whether therapy is even necessary.
Quinolone resistance is increasing. – Infants (S aureus, including Empiric therapy: clindamycin (to cover CA-MRSA). For Oral therapy options: CA-MRSA; group A serious infections, ADD cefazolin to provide better For CA-MRSA: clindamycin OR linezolid40 streptococcus; Kingella MSSA coverage and add Kingella coverage For MSSA: cephalexin OR dicloxacillin kingae; in unimmunized or For CA-MRSA: clindamycin 30 mg/kg/day IV div q8h or For Kingella, most penicillins or cephalosporins (but not immune-compromised vancomycin 40 mg/kg/day IV q8h clindamycin) children: pneumococcus, For MSSA: oxacillin 150 mg/kg/day IV div q6h OR H influenzae type b) cefazolin 100 mg/kg/day IV div q8h Total therapy (IV plus PO) for 3 wks with normal ESR; – Children (S aureus, including For Kingella: cefazolin, ampicillin, or ceftriaxone 50 mg/ low-risk, non-hip arthritis may respond to a 10-day CA-MRSA; group A kg/day IV, IM q24h course.
May also be dosed as 25–50 mg/m2 qd for all age groups. e Cefepime should be given at 60 mg/kg/day div q12h for the first 2 weeks of age, after which the dosing increases to 100 mg/kg/day div q12h. For meningitis or Pseudomonas infections, dosage is 150 mg/kg/day div q8h. f 25–50 mg/kg (maximum 125 mg) as single dose for gonococcal eye prophylaxis or treatment. g Increase to 150/mg/kg/day to achieve serum concentration of 50–70 μg/mL. h 3TC is provided from birth to 1 week of age. Use of antiretroviral drugs other than zidovudine cannot be recommended in premature infants due to lack of dosing and safety data.
2010-2011 Nelson's Pocket Book of Pediatric Antimicrobial Therapy by John S. Bradley MD, John D. Nelson MD Emeritus