BNF for Children 2011-2012

BNFC 2011–2012 5.1 Antibacterial drugs 245Campylobacter enteritisFrequently self-limiting; treat if immunocompromised or if severe infection.Clarithromycin 1Alternative, ciprofloxacinSalmonella (non-typhoid)Treat invasive or severe infection. Do not treat less severe infection unless there is a risk of developing invasiveinfection (e.g. immunocompromised children, those with haemoglobinopathy, or children under 6 months of age).Ciprofloxacin or cefotaximeShigellosisAntibacterial not indicated for mild cases.Azithromycin or ciprofloxacinAlternatives if micro-organism sensitive, amoxicillin or trimethoprimTyphoid feverInfections from Middle-East, South Asia, and South-East Asia may be multiple-antibacterial-resistant and sensitivityshould be tested.Cefotaxime 2Azithromycin may be an alternative in mild or moderate disease caused by multiple-antibacterial-resistantmicro-organismsAlternative, ciprofloxacin or chloramphenicolStrains with decreased sensitivity to ciprofloxacin being isolatedClostridium difficile infectionOral metronidazoleSuggested duration of treatment 10–14 daysFor third or subsequent episode of infection, for severe infection, for infection not respondingto metronidazole, or in children intolerant of metronidazole, oral vancomycinSuggested duration of treatment 10–14 daysFor infection not responding to vancomycin, or for life-threatening infection, or in patientswith ileus, oral vancomycin + i/v metronidazoleSuggested duration of treatment 10–14 days5 InfectionsNecrotising enterocolitis in neonatesBenzylpenicillin + gentamicin + metronidazole or amoxicillin 3 + gentamicin + metronidazoleor amoxicillin 3 + cefotaxime + metronidazolePeritonitisA cephalosporin + metronidazole or amoxicillin + gentamicin + metronidazole or piperacillinwith tazobactam alonePeritonitis: peritoneal dialysis-associatedVancomycin 4 + ceftazidime added to dialysis fluid or vancomycin added to dialysis fluid +ciprofloxacin by mouthSuggested duration of treatment 14 days or longer1. Where clarithromycin is suggested azithromycin or erythromycin may be used2. Where cefotaxime is suggested ceftriaxone may be used3. Where amoxicillin is suggested ampicillin may be used4. Where vancomycin is suggested teicoplanin may be used