BNF for Children 2011-2012

BNFC 2011–2012 5.1 Antibacterial drugs 255Prevention of pneumococcal infection inasplenia or in patients with sickle-celldiseasePhenoxymethylpenicillin by mouthChild under 1 year 62.5 mg twice dailyChild 1–5 years 125 mg twice dailyChild 5–18 years 250 mg twice dailyIf cover also needed for H. influenzae in child giveamoxicillin insteadChild 1 month–5 years 125 mg twice dailyChild 5–12 years 250 mg twice dailyChild 12–18 years 500 mg twice dailyIf penicillin-allergic, erythromycin by mouthChild 1 month–2 years 125 mg twice dailyChild 2–8 years 250 mg twice dailyChild 8–18 years 500 mg twice dailyNote Antibacterial prophylaxis is not fully reliable; for vaccinesin asplenia see p. 602. Antibacterial prophylaxis may be discontinuedin children over 5 years of age with sickle-celldisease who have received pneumococcal immunisationPrevention of Staphylococcus aureus lunginfection in cystic fibrosisPrimary prevention, flucloxacillin by mouthNeonate 125 mg every 12 hoursChild 1 month–3 years 125 mg every 12 hoursSecondary prevention, flucloxacillin by mouthChild 1 month–18 years 50 mg/kg (max. 1 g) every 12hoursPrevention of tuberculosis in susceptibleclose contacts or those who have becometuberculin positive 1Isoniazid for 6 monthsNeonate 10 mg/kg dailyChild 1 month –12 years 10 mg/kg daily (max. 300 mgdaily)Child 12–18 years 300 mg dailyor isoniazid + rifampicin for 3 monthsChild 1 month–12 years isoniazid 10 mg/kg daily(max. 300 mg daily) + rifampicin 10 mg/kg daily (max.450 mg daily if body-weight less than 50 kg; max.600 mg daily if body-weight over 50 kg)Child 12–18 years isoniazid 300 mg daily + rifampicin600 mg daily (rifampicin 450 mg daily if body-weightless than 50 kg)or (if isoniazid-resistant tuberculosis) rifampicin for 6monthsChild 1 month–12 years 10 mg/kg daily (max. 450 mgdaily if body-weight less than 50 kg; max. 600 mg daily ifbody-weight over 50 kg)Child 12–18 years 600 mg daily (450 mg daily if bodyweightless than 50 kg)1. For details of those who should receive chemoprophylaxiscontact the lead clinician for local tuberculosis services (ora consultant in communicable disease control). See alsosection 5.1.9, for advice on immunocompromised patientsand on prevention of tuberculosisPrevention of urinary-tract infectionTrimethoprim by mouthNeonate 2 mg/kg at nightChild 1 month–12 years 2 mg/kg (max. 100 mg) atnightorChild 6 weeks–6 months 12.5 mg at nightChild 6 months–6 years 25 mg at nightChild 6–12 years 50 mg at nightChild 12–18 years 100 mg at nightor nitrofurantoin by mouthChild 3 months–12 years 1 mg/kg at nightChild 12–18 years 50–100 mg at nightAntibacterial prophylaxis can be considered for recurrent infection,significant urinary-tract anomalies, or significant kidneydamage. See also section 5.1.13Prevention of gas-gangrene in high lowerlimbamputations or following major traumai/v benzylpenicillinChild 1 month–12 years 25 mg/kg (max. 600 mg)every 6 hours for 5 daysChild 12–18 years 300–600 mg every 6 hours for 5 daysor if penicillin-allergic i/v or oral metronidazoleChild 1 month–12 years 7.5 mg/kg (max. 500 mg)every 8 hours for 5 daysChild 12–18 years 400–500 mg every 8 hours for 5 daysPrevention of infection in gastro-intestinalproceduresOperations on stomach or oesophagus 2Single dose 3 of i/v gentamicin or i/v cefuroxime or i/vco-amoxiclavAdd i/v teicoplanin 4 if high risk of meticillin-resistant StaphylococcusaureusOpen biliary surgery 2Single dose 3 of i/v cefuroxime + i/v metronidazole 5 ori/v gentamicin + i/v metronidazole 5 or i/v co-amoxiclavaloneAdd i/v teicoplanin 4 if high risk of meticillin-resistant Staphylococcusaureus2. Intravenous antibacterial prophylaxis should be given up to30 minutes before the procedure3. Additional intra-operative or postoperative doses of antibacterialmay be given for prolonged procedures or if thereis major blood loss4. Where teicoplanin is suggested vancomycin may be used5. Metronidazole may alternatively be given by suppositorybut to allow adequate absorption, it should be given 2hours before surgery5 Infections