BNF for Children 2011-2012

254 5.1 Antibacterial drugs BNFC 2011–20125 InfectionsTable 2. Summary of antibacterialprophylaxisPrevention of recurrence of rheumatic feverPhenoxymethylpenicillin by mouthChild 1 month–6 years 125 mg twice dailyChild 6–18 years 250 mg twice dailyorErythromycin by mouthChild 1 month–2 years 125 mg twice dailyChild 2–18 years 250 mg twice dailyPrevention of secondary case of invasivegroup A streptococcal infection 1Phenoxymethylpenicillin by mouthNeonate 12.5 mg/kg (max. 62.5 mg) every 6 hours for10 daysChild 1 month–1 year 62.5 mg every 6 hours for 10daysChild 1–6 years 125 mg every 6 hours for 10 daysChild 6–12 years 250 mg every 6 hours for 10 daysChild 12–18 years 250–500 mg every 6 hours for 10daysIf child penicillin allergic,either erythromycin by mouthChild 1 month–2 years 125 mg every 6 hours for 10daysChild 2–8 years 250 mg every 6 hours for 10 daysChild 8–18 years 250–500 mg every 6 hours for 10 daysor azithromycin by mouth [unlicensed indication]Child 6 months–12 years 12 mg/kg (max. 500 mg)once daily for 5 daysChild 12–18 years 500 mg once daily for 5 daysPrevention of secondary case ofmeningococcal meningitis 2Ciprofloxacin by mouth [unlicensed indication]Child 1 month–5 years 125 mg as a single doseChild 5–12 years 250 mg as a single doseChild 12–18 years 500 mg as a single doseor1. For details of those who should receive chemoprophylaxiscontact a consultant in communicable disease control (or aconsultant in infectious diseases or the local HealthProtection Agency Laboratory)2. For details of those who should receive chemoprophylaxiscontact a consultant in communicable disease control (or aconsultant in infectious diseases or the local HealthProtection Agency laboratory). Unless there has beendirect exposure of the mouth or nose to infectious dropletsfrom a patient with meningococcal disease who hasreceived less than 24 hours of antibacterial treatment,healthcare workers do not generally require chemoprophylaxisRifampicin by mouthNeonate 5 mg/kg every 12 hours for 2 daysChild 1 month–1 year 5 mg/kg every 12 hours for 2daysChild 1–12 years 10 mg/kg (max. 600 mg) every 12hours for 2 daysChild 12–18 years 600 mg every 12 hours for 2 daysorCeftriaxone by intramuscular injection [unlicensed indication]Child 1 month–12 years 125 mg as a single doseChild 12–18 years 250 mg as a single dosePrevention of secondary case ofHaemophilus influenzae type b disease 2Rifampicin by mouthChild 1–3 months 10 mg/kg once daily for 4 daysChild 3 months–12 years 20 mg/kg (max. 600 mg)once daily for 4 daysChild 12–18 years 600 mg once daily for 4 daysPrevention of secondary case of diphtheriain non-immune patientErythromycin 3 by mouthChild 1 month–2 years 125 mg every 6 hours for 7 daysChild 2–8 years 250 mg every 6 hours for 7 daysChild 8–18 years 500 mg every 6 hours for 7 daysTreat for further 10 days if nasopharyngeal swabs positiveafter first 7 days’ treatment. For immunisation again diphtheriasee section 14.4Prevention of pertussisClarithromycin 4 by mouthNeonate 7.5 mg/kg twice daily for 7 daysChild 1 month–12 yearsBody-weight under 8 kg 7.5 mg/kg twice daily for 7daysBody-weight 8–11 kg 62.5 mg twice daily for 7 daysBody-weight 12–19 kg 125 mg twice daily for 7 daysBody-weight 20–29 kg 187.5 mg twice daily for 7 daysBody-weight 30–40 kg 250 mg twice daily for 7 daysChild 12–18 years 500 mg twice daily for 7 daysWithin 3 weeks of onset of cough in the index case, giveantibacterial prophylaxis to vulnerable close contacts and toother close contacts who are in contact with vulnerable individuals.Vulnerable contacts include neonates, unimmunised orpartially immunised children under 10 years of age, females inthe last month of pregnancy, the immunocompromised, orthose with chronic illness (e.g. asthma, congenital heart disease).For immunisation against pertussis see section 14.43. Where erythromycin is suggested another macrolide (e.g.azithromycin or clarithromycin) may be used4. Where clarithromycin is suggested azithromycin or erythromycinmay be used