By John S. Bradley MD, John D. Nelson MD Emeritus
Read or Download 2010-2011 Nelson's Pocket Book of Pediatric Antimicrobial Therapy PDF
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Additional info for 2010-2011 Nelson's Pocket Book of Pediatric Antimicrobial Therapy
Pyoderma, cutaneous For prevention of recurrent CA-MRSA infection, use bleach abscesses cloxacillin 50 mg/kg/day PO div qid OR amox/clav (S aureus, including CA-MRSA; 45 mg/kg/day PO div tid (BII) baths (1/2 cup of bleach per full bathtub) (BII), OR bathe group A streptococcus)2,5–7,28–30 CA-MRSA: clindamycin 30 mg/kg/day PO div tid (BII) with chlorhexidine soap. Decolonization with mupirocin OR TMP/SMX 8 mg/kg/day of TMP PO div bid (CIII) may also be helpful. )38,39 See Chapter 5. indd 35 – Other bacteria See Chapter 7 for preferred antibiotics.
Single dose (AII) Once daily amoxicillin dosage: for children >3 years of For penicillin-allergic children: erythromycin (estolate at age and <40 kg: 750 mg once daily; for those >40 kg, 20–40 mg/kg/day PO div bid to qid; or ethylsuccinate 1,000 mg once daily. 94 Peritonsillar cellulitis or Clindamycin 30 mg/kg/day PO, IV, IM div q8h AND Consider incision and drainage for abscess abscess cefotaxime 150 mg/kg/day IV div q8h (BIII) Alternatives: meropenem or imipenem; PIP/TAZO; amox/ (group A streptococcus with clav for convalescent oral therapy (BIII) No useful data on benefits of steroids mixed oral flora)89,90 Empiric: meropenem 60 mg/kg/day div q8h (or 120 Anecdotal reports suggest metronidazole may be Lemierre syndrome (Fusobacterium necrophorum)88 mg/kg/day div q8h for CNS metastatic foci) (AIII) OR effective for apparent failures with other agents.
Indd 34 Staphylococcal scalded skin Standard: oxacillin 150 mg/kg/day IV div q6h OR Burow’s or Zephiran compresses for oozing skin and syndrome6,32 cefazolin 100 mg/kg/day IV div q8h (CII) intertriginous areas CA-MRSA: clindamycin 30 mg/kg/day IV div q8h (CIII) Corticosteroids are contraindicated or vancomycin 40 mg/kg/day IV q8h (CIII) Rat-bite fever Penicillin G 100,000–200,000 U/kg/day IV div q6h (BII) Organisms are normal oral flora for rodents (Streptobacillus moniliformis, x 7–10 d; for endocarditis, ADD gentamicin x 4–6 wks Alternatives: doxycycline; 2nd and 3rd generation Spirillum minus)31 (CIII) cephalosporins (CIII) For mild disease, oral therapy with amox/clav (CIII) Standard: cephalexin 50–75 mg/kg/day PO div tid OR I&D when indicated; IV for serious infections.