University Hospital of Wales Paediatric Intensive Care Unit Guideline Printed on Wed 23-jul-08
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Last updated August 17, 2017 10:37 AM

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02920 744622

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Noah's Ark Childrens Hospital for Wales
Heath Park
Cardiff
CF14 4XW
02920 747747


Antibiotic policy

The doses stated here are for intravenous antibiotics and assume normal renal and hepatic function - check the BNF-C for dosage adjustments in children with renal or hepatic failure.

 


Sepsis/Meningitis

 

< 1 month

1-3 months

> 3 months

Sepsis
(Unidentified
Origin)

Cefotaxime 50mg/kg BD under 7 days; 50mg/kg TDS 7 - 28 days

plus

Amoxicillin 50mg/kg BD under 7 days; 50mg/kg TDS 7 - 28 days

Cefotaxime 50mg/kg QDS

plus

Amoxicillin 50mg/kg QDS (max 2g 4 hourly)

Cefotaxime 50mg/kg QDS (max 12 g daily)

Meningo-
encephalitis

Cefotaxime 50mg/kg BD under 7 days; 50mg/kg TDS 7 - 28 days

plus

Amoxicillin 100mg/kg BD under 7 days; 100mg/kg TDS 7 - 28 days

plus

Aciclovir 20mg/kg TDS

Cefotaxime 50mg/kg QDS

plus

Amoxicillin 50mg/kg (max 2g) QDS

plus

Aciclovir 20mg/kg TDS

Cefotaxime 50mg/kg QDS (max 12 g daily)

plus

Clarithromycin 7.5mg/kg (max 500mg) BD

plus

Aciclovir
<12 years 500mg/m2 TDS

>12 years 10mg/kg TDS

 

 


 

Pneumonia

 

< 1 month

< 5 years

> 5 years

Immuno-compromised

First Line

Cefotaxime 50mg/kg BD under 7 days; 50mg/kg TDS 7 - 28 days

plus

Amoxicillin 60mg/kg BD under 7 days; 60mg/kg TDS 7 - 28 days

Augmentin 30mg/kg TDS
(can increase to QDS in sever infections if over 3 months old)

Augmentin 30mg/kg TDS (max 1.2g )

plus

Clarithromycin 7.5mg/kg (max 500mg) BD

Tazocin 90mg/kg (max 4.5g) TDS if < 1 month; QDS (1 month - 12yrs)

plus

Gentamicin see BNFC
plus

Clarithromycin 7.5mg/kg (max 500mg) BD

Second Line (if already treated with above >48 hrs prior to admission to PICU)

Per previous NBL result & after discussion with microbiology

Organisms

Group B Strep, S. aureus, GNB, E. Coli, listeria +/- Chlamydia

S. pneumoniae, B. pertussis, Group A strep, S. aureus (post viral) Anaerobes (abscess)

S. pneumoniae, Group A strep, S. aureus (post viral), mycoplasma Anaerobes (abscess)

S. pneumoniae,
Group A strep,
S. aureus, GNB
pseudomonas,
legionella
mycoplasma Anaerobes

 


 

Neurosurgical

Cerebral/Subdural Abscess Unknown Source

Flucloxacillin 50mg /kg
<7 days BD
7 - 21 days TDS
>21 days QDS (max 1g QDS)

plus

Ceftriaxone 80mg/kg daily (< 1 month 50mg/kg)

plus

Metronidazole
neonate 15mg/kg load, then 24 hours later 7.5mg/kg BD
> 1 month - 7.5mg/kg TDS (max 500mg)

Cerebral/Subdural Abscess Related to Otitis media

Flucloxacillin 50mg /kg
<7 days BD
7 - 21 days TDS
>21 days QDS (max 1g QDS)

plus

Ceftazidime 50mg/kg
<7 days once daily
7 - 21 days BD
>21 days TDS
Max dose 6g daily

plus

Metronidazole
neonate 15mg/kg load, then 24 hours later 7.5mg/kg BD
> 1 month - 7.5mg/kg TDS (max 500mg)

VP shunt Infection

Vancomycin see BNF-C for doasgae schedule

plus

Ceftazidime 50mg/kg
<7 days once daily
7 - 21 days BD
>21 days TDS
Max dose 6g daily

Base of Skull # with CSF leak

None

Compound skull #

Augmentin 30mg/kg TDS (BD if < 7 days old)