BNF for Children 2011-2012

BNFC 2011–2012 5.1 Antibacterial drugs 251Musculoskeletal systemOsteomyelitisSeek specialist advice if chronic infection or prostheses present.FlucloxacillinConsider adding fusidic acid or rifampicin for initial 2 weeks.Suggested duration of treatment 6 weeks for acute infectionIf penicillin-allergic, clindamycinConsider adding fusidic acid or rifampicin for initial 2 weeks.Suggested duration of treatment 6 weeks for acute infectionIf meticillin-resistant Staphylococcus aureus suspected, vancomycin 1Consider adding fusidic acid or rifampicin for initial 2 weeks.Suggested duration of treatment 6 weeks for acute infectionSeptic arthritisSeek specialist advice if prostheses present.FlucloxacillinSuggested duration of treatment 4–6 weeks (longer if infection complicated)If penicillin-allergic, clindamycinSuggested duration of treatment 4–6 weeks (longer if infection complicated)If meticillin-resistant Staphylococcus aureus suspected, vancomycin 1Suggested duration of treatment 4–6 weeks (longer if infection complicated)If gonococcal arthritis or Gram-negative infection suspected, cefotaxime 2Suggested duration of treatment 4–6 weeks (longer if infection complicated; treat gonococcal infection for2 weeks)EyePurulent conjunctivitisNeonate, chloramphenicol or neomycin eye dropsSee also section 11.3.1Child 1 month–18 years, chloramphenicol eye-dropsSee also section 11.3.15 InfectionsCongenital chlamydial conjunctivitisErythromycin (by mouth)Suggested duration of treatment 14 daysCongenital gonococcal conjunctivitisCefotaxime 2Suggested duration of treatment single-doseEar, nose, and oropharynxPericoronitisAntibacterial required only in presence of systemic features of infection, or of trismus, or persistent swelling despitelocal treatment.MetronidazoleSuggested duration of treatment 3 days or until symptoms resolveAlternative, amoxicillinSuggested duration of treatment 3 days or until symptoms resolve1. Where vancomycin is suggested teicoplanin may be used2. Where cefotaxime is suggested ceftriaxone may be used