Pediatric dosing of antimicrobials: Difference between revisions

From IDWiki
(: added macrolides)
(: added aminoglycosides)
Line 275: Line 275:
 
| 20 mg/kg once daily for 3 days
 
| 20 mg/kg once daily for 3 days
 
|}
 
|}
  +
  +
=== Aminoglycosides ===
  +
  +
{| class="wikitable"
  +
! Drug
  +
! Indication
  +
! Age and weight
  +
! Dose
  +
|-
  +
| rowspan=2 | [[Tobramycin]] IV
  +
| usual dose
  +
|
  +
| 5-7 mg/kg/dose q24h
  +
|-
  +
| [[cystic fibrosis]]
  +
|
  +
| 10-12 mg/kg/dose q24h
  +
|-
  +
| [[Tobramycin]] INH
  +
| [[cystic fibrosis]]
  +
|
  +
| 80 mg bid to tid
  +
|-
  +
| rowspan=4 | [[Gentamicin]] IV
  +
| rowspan=3 | usual dose
  +
| ≤7 days
  +
| 4 mg/kg/dose q24h
  +
|-
  +
| >7 days
  +
| 5 mg/kg/dose q24h
  +
|-
  +
| infants and children
  +
| 5-7 mg/kg/dose q24h
  +
|-
  +
| synergy for Gram-positive infections
  +
| 1 mg/kg/dose q8h
  +
|}
  +
  +
* Extended-frequency dosing of aminoglycosides is preferred for all patients older than 1 month with the exception of endocarditis or extensive burns
  +
* Monitor trough levels pre-second dose, with target of <1 mg/L
   
 
[[Category:Antimicrobials]]
 
[[Category:Antimicrobials]]

Revision as of 22:19, 18 November 2019

Antibiotics

Penicillins

Drug Indication Age and weight Dose
Penicillin G IV/IM moderate to severe infections 100,000 to 400,000 U/kg/day split q4-6h (max 24 MU/day)
meningitis 400,000 U/kg/day split q4h (max 24 MU/day)
Penicillin VK PO mild to moderate infections 25-50 mg/kg/day split q8-12h
rheumatic fever (treatment) ≤ 27 kg 300 mg PO bid x10 days
> 27 kg 600 mg PO bid x 10 days
rheumatic fever (prophylaxis) > 5 years 300 mg PO bid
asplenia (prophylaxis) 6 months to 5 years 150 mg PO bid
> 5 years 300 mg PO bid
Cloxacillin IV methicillin-susceptible Staphylococcus aureus 100-200 mg/kg/day split q4-6h (max 2g/dose and 12 g/day)
Cloxacillin PO use cephalexin instead
Ampicillin IV usual dose neonates 100-200 mg/kg/day split q6-8h
infants and children 100-200 mg/kg/day split q6h (max 2 g/dose)
meningitis neonates 300 mg/kg/day split q6-8h
infants and children 300-400 mg/kg/day split q4-6h (max 2 g/dose)
Amoxicillin PO usual dose 40-50 mg/kg/day split q8h
Streptococcus pneumoniae 80-90 mg/kg/day split q8h
Group A Streptococcus pharyngitis 50 mg/kg once daily x10 days (max 1 g/dose)
Amoxicillin-clavulanic acid PO usual dose 30-50 mg/kg/day (amox component) split q8-12h (max 875 mg/dose)
Streptococcus pneumoniae 80-90 mg/kg/day (amox component) split q8-12h (max 875 mg/dose)
Piperacillin-tazobactam IV usual dose 240-300 mg/kg/day (pip component) split q6-8h
Pseudomonas aeruginosa or cystic fibrosis 400 mg/kg/day split q6h

Cephalosporins

Drug Indication Age and weight Dose
First generation
Cefazolin IV/IM usual dose 75-150 mg/kg/day split q8h (max 2 g/dose and 6 g/day)
Cephalexin PO usual dose 25-100 mg/kg/day split qid
osteomyelitis (oral step-down) 100-150 mg/kg/day split qid
Second generation
Cefuroxime IV/IM usual dose 100-150 mg/kg/day split q8h (max 2 g/dose)
Cefuroxime azetil PO poor bioavailability; not recommended
Cefprozil PO usual dose 15-30 mg/kg/day split bid (max 1 g/day)
Third generation
Cefotaxime IV/IM usual dose 0-7 days 50 mg/kg/dose q8h
>7 days 50 mg/kg/dose q8h
infants and children 100-200 mg/kg/day split q6-8h (max 6 g/day)
meningitis 0-7 days 50 mg/kg/dose q8h
>7 days 50 mg/kg/dose q6h
infants and children 200-300 mg/kg/day split q6h (max 4 g/dose and 12 g/day)
Ceftriaxone IM/IV usual dose >1 month 50-75 mg/kg q24h (max 2 g/day)
meningitis >1 month 100 mg/kg/day split q12-24h (max 2 g/dose and 4 g/day)
gonorrhea ≥9 years 250 mg IM once
<9 years 50 mg/kg IM once (max 250 mg)
Ceftazidime IM/IV usual dose 75-150 mg/kg/day split q8h (max 2 g/dose and 6 g/day)
meningitis or cystic fibrosis 200 mg/kg/day split q6-8h (max 6 g/day)
Cefixime PO usual dose 8 mg/kg/day split q12-24h (max 400 mg/day)

Carbapenems

Drug Indication Age and weight Dose
Meropenem usual dose 20 mg/kg/dose q8h (max 1 g/dose)
meningitis 40 mg/kg/dose q8h (max 2 g/dose)
Ertapenem usual dose 3 months to 12 years 15 mg/kg/dose q12h (max 500 mg/dose)
≥13 years 1 g daily

Glycopeptides

Drug Indication Age and weight Dose
Vancomycin IV usual dose 40-60 mg/kg/day split q6-12h (max 2+ g/day)
meningitis or MRSA 60 mg/kg/day split q6-8h (max 4 g/day)
Vancomycin PO Clostridium difficile 10 mg/kg/dose q6h (max 125 mg/dose)

Macrolides

Drug Indication Age and weight Dose
Clarithromycin PO usual dose 7.5 mg/kg/dose bid
Azithromycin PO/IV usual dose 10 mg/kg (max 500 mg) once, then 5 mg/kg (max 250 mg) daily for 4 days
pertussis <6 months 10 mg/kg q24h for 5 days
≥6 months 10 mg/kg once (max 500 mg) then 5 mg/kg dailys (max 250 mg)
chlamydia <9 years 20 mg/kg (max 1 g) once
≥9 years 1 g once
chlamydial conjunctivitis infants 20 mg/kg once daily for 3 days

Aminoglycosides

Drug Indication Age and weight Dose
Tobramycin IV usual dose 5-7 mg/kg/dose q24h
cystic fibrosis 10-12 mg/kg/dose q24h
Tobramycin INH cystic fibrosis 80 mg bid to tid
Gentamicin IV usual dose ≤7 days 4 mg/kg/dose q24h
>7 days 5 mg/kg/dose q24h
infants and children 5-7 mg/kg/dose q24h
synergy for Gram-positive infections 1 mg/kg/dose q8h
  • Extended-frequency dosing of aminoglycosides is preferred for all patients older than 1 month with the exception of endocarditis or extensive burns
  • Monitor trough levels pre-second dose, with target of <1 mg/L