BNF for Children 2011-2012

262 5.1.1 Penicillins BNFC 2011–20125 Infections100 mL = £1.22; 250 mg/5 mL, 100 mL = £1.39.Label: 9Note Sugar-free versions are available and can be ordered byspecifying ‘sugar-free’ on the prescriptionBrands include Amoram c , Galenamox c , Rimoxallin cDental prescribing on NHS Amoxicillin Oral Suspensionmay be prescribedInjection, powder for reconstitution, amoxicillin (assodium salt), net price 250-mg vial = 32p; 500-mg vial= 66p; 1-g vial = £1.16Amoxil c (GSK) ACapsules, both maroon/gold, amoxicillin (as trihydrate),250 mg, net price 21-cap pack = £3.45; 500 mg,21-cap pack = £6.91. Label: 9Paediatric suspension, amoxicillin 125 mg (as trihydrate)/1.25mL when reconstituted with water, netprice 20 mL (peach- strawberry- and lemon-flavoured)= £3.25. Label: 9, counselling, use of pipetteExcipients include sucrose 600 mg/1.25 mLInjection, powder for reconstitution, amoxicillin (assodium salt), net price 500-mg vial = 56p; 1-g vial =£1.12Electrolytes Na + 3.3 mmol/gAMPICILLINCautions history of allergy; erythematous rashescommon in glandular fever (see notes above);increased risk of erythematous rashes in cytomegalovirusinfection, and acute or chronic lymphocyticleukaemia (see notes above); interactions:Appendix 1 (penicillins)Contra-indications penicillin hypersensitivityRenal impairment if estimated glomerular filtrationrate less than 10 mL/minute/1.73 m 2 reduce dose orfrequency—rashes more commonPregnancy not known to be harmfulBreast-feeding trace amounts in milk—not known tobe harmful but be alert for hypersensitivity in infantSide-effects nausea, vomiting, diarrhoea; rashes (discontinuetreatment); rarely, antibiotic-associated colitis;see also under Benzylpenicillin (section 5.1.1.1)Indication and doseSusceptible infections including urinary-tractinfections, otitis media, sinusitis, uncomplicatedcommunity-acquired pneumonia, oralinfections (Table 1, section 5.1), salmonellosis. By mouthNeonate under 7 days 30 mg/kg (max. 62.5 mg)twice daily; dose doubled in severe infectionNeonate 7–21 days 30 mg/kg (max. 62.5 mg) 3times daily; dose doubled in severe infectionNeonate 21–28 days 30 mg/kg (max. 62.5 mg) 4times daily; dose doubled in severe infectionChild 1 month–1 year 62.5 mg 4 times daily; dosedoubled in severe infection, community-acquiredpneumonia, or salmonellosisChild 1–5 years 125 mg 4 times daily; dosedoubled in severe infection, community-acquiredpneumonia, or salmonellosisChild 5–12 years 250 mg 4 times daily; dosedoubled in severe infection, community-acquiredpneumonia, or salmonellosisChild 12–18 years 250–500 mg 4 times daily;dose doubled in severe infection. By intravenous injection or infusionNeonate under 7 days 30 mg/kg every 12 hours;dose doubled in severe infection, communityacquiredpneumonia, or salmonellosisNeonate 7–21 days 30 mg/kg every 8 hours;dose doubled in severe infection, communityacquiredpneumonia, or salmonellosisNeonate 21–28 days 30 mg/kg every 6 hours;dose doubled in severe infection, communityacquiredpneumonia, or salmonellosisChild 1 month–18 years 25 mg/kg (max. 500 mg)every 6 hours; dose doubled in severe infectionListerial meningitis, group B streptococcalinfection, enterococcal endocarditis (in combinationwith another antibacterial, see Table 1, section5.1). By intravenous infusionNeonate under 7 days 50 mg/kg every 12 hours;dose doubled in meningitisNeonate 7–21 days 50 mg/kg every 8 hours;dose doubled in meningitisNeonate 21–28 days 50 mg/kg every 6 hours;dose doubled in meningitisChild 1 month–18 years 50 mg/kg every 4–6hours (max. 2 g every 4 hours)Administration Oral: administer at least 30 minutesbefore foodInjection: displacement value may be significant whenreconstituting injection, consult local guidelines.Dilute intravenous injection to a concentration of 50–100 mg/mL. May be further diluted with glucose 5%or 10% or sodium chloride 0.9% or 0.45% for infusion.Give over 30 minutes when using doses of greaterthan 50 mg/kg to avoid CNS toxicity including convulsions.Ampicillin (Non-proprietary) ACapsules, ampicillin 250 mg, net price 28 = £7.18;500 mg, 28 = £32.93. Label: 9, 23Brands include Rimacillin cDental prescribing on NHS Ampicillin Capsules may beprescribedOral suspension, ampicillin 125 mg/5 mL whenreconstituted with water, net price 100 mL = £9.23;250 mg/5 mL, 100 mL = £14.17. Label: 9, 23Brands include Rimacillin cDental prescribing on NHS Ampicillin Oral Suspension maybe prescribedInjection, powder for reconstitution, ampicillin (assodium salt), net price 500-mg vial = £7.83Penbritin c (Chemidex) ACapsules, both grey/red, ampicillin (as trihydrate)250 mg, net price 28-cap pack = £2.10; 500 mg, 28-cappack = £5.28. Label: 9, 23Syrup, apricot- caramel- and peppermint-flavoured,ampicillin (as trihydrate) for reconstitution with water,125 mg/5 mL, net price 100 mL = £3.78; 250 mg/5 mL, 100 mL = £7.39. Label: 9, 23Excipients include sucrose 3.6 g/5 mL