Exam

Paediatric antibiotic & antifungal dosage & route

Antibiotic treatment for meningitis in children

Antibiotic Dosage
Amikacin
  • 15-20 mg/kg/day
    as a single daily dose
    Neonates: Adjust dose and frequency based on postnatal age and renal function
Amoxicillin-ampicillin
  • First week of life (7 days or less):
    50 mg/kg/dose
    8 hourly
  • 8 days of age & older:
    50 mg/kg/ dose
    6 hourly
Cefazoline
  • First week of life (7 days or less):
    50 mg/kg/dose
    12 hourly
  • 8 days of age & older:
    50 mg/kg/dose
    8 hourly
Ceftriaxone
  • 50 mg/kg/day
    Intravenous: in 1 dose to 50 mg/kg/dose 12 hourly (meningitis)
    Maximum dose: 4g/d
Cefotaxime
  • 100-150mg/kg/d in 3 or 4 doses
    Maximum dose: 12g/d
  • Meningitidis: 200-300mg/kg/d
Ciprofloxacin
  • Oral dosage:
    10-20 mg/kg/dose
    every 12 hours
    Maximum: 500 mg/dose
  • Intravenous dosage:
    6-10 mg/kg/dose
    every 8-12 hours
    Maximum: 400 mg/dose
(flu)cloxacillin
  • 200 mg/kg/d
    Intravenous: in 4–6 divided doses
  • First week of life (7 days or less):
    50 mg/ kg/dose
    12 hourly
  • 8-28 days:
    50 mg/kg/ dose
    8 hourly
  • Older than 28 days:
    50 mg/kg/dose
    6 hourly
    Maximum dose: 3 g 6 hourly
Cotrimoxazole (Trimethoprim/Sulfamethoxazole)
  • Oral or intravenous dosage based on Trimethoprim component:
    5-10 mg/kg/day divided into 2 doses
    every 12 hours
    Maximum dose: 320 mg/day (Trimethoprim component)
  • For severe infections (e.g., Pneumocystis jirovecii pneumonia):
    15-20 mg/kg/day of Trimethoprim in 3–4 divided doses
Gentamicin
  • 3 mg/kg/day in 1 dose
    Maximum dose: 360 mg
Meropenem
  • 20 mg/kg/dose
    every 8 hours
    Maximum dose: 2 g/dose
  • For meningitis:
    40 mg/kg/dose
    every 8 hours
Metronidazole
  • First week of life (7 days or less):
    7.5 mg/kg/dose
    12 hourly
  • 8 days of age & older:
    7.5 mg/kg/dose
    8 hourly
    Maximum dose: 400 mg 8 hourly
Penicillin G
  • 200 000 U/kg/day
    Intravenous: in 4–6 divided doses
Piperacillin/tazobactam
  • First week of life (7 days or less):
    100 mg/kg/dose
    12 hourly
  • 8 days of age & older:
    100 mg/kg/dose
    8 hourly
Vancomycin
  • 30 mg/kg/day
    Intravenous : in 2–3 equally divided doses
  • If septic shock or endocarditis: Vancomycin
    40 mg/kg/day
    Intravenous : in 2–3 equally divided doses
Antibiotic Dosage
Amphotericin B Deoxycholate
  • 0.5-1 mg/kg/day
Caspofungin
  • Neonates/Infants <3 months:
    25 mg/m2/day, adjust as needed
  • Between 3 and 11 months:
    50 mg/m2/day, adjust as needed
  • After 11 months:
    Loading dose of 70 mg/m2 on day 1, followed by 50 mg/m2/day
    Maximum dose: 70 mg/day
Fluconazole
  • 6-12 mg/kg/day once daily
    Maximum dose: 400 mg/day
Liposomal Amphotericin B
  • 3-5 mg/kg/day for most fungal infections

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