BNF for Children 2011-2012

268 5.1.2 Cephalosporins, carbapenems, and other beta-lactams BNFC 2011–20125 InfectionsIndication and doseInfections due to sensitive Gram-positive andGram-negative bacteria but see notes above. By mouthNeonate under 7 days 25 mg/kg (max. 125 mg)twice dailyNeonate 7–21 days 25 mg/kg (max. 125 mg) 3times dailyNeonate 21–28 days 25 mg/kg (max. 125 mg) 4times dailyChild 1 month–12 years 12.5 mg/kg twice daily;dose doubled in severe infection; max. 25 mg/kg 4times daily (max. 1 g 4 times daily)orChild 1 month–1 year 125 mg twice dailyChild 1–5 years 125 mg 3 times dailyChild 5–12 years 250 mg 3 times dailyChild 12–18 years 500 mg 2–3 times daily,increased to 1–1.5 g 3–4 times daily for severeinfectionProphylaxis of recurrent urinary-tract infection. By mouthChild 1 month–18 years 12.5 mg/kg at night(max. 125 mg at night)Cefalexin (Non-proprietary) ACapsules, cefalexin 250 mg, net price 28-cap pack =£1.66; 500 mg, 21-cap pack = £2.09. Label: 9Dental prescribing on NHS Cefalexin Capsules may beprescribedTablets, cefalexin 250 mg, net price 28-tab pack =£1.94; 500 mg, 21-tab pack = £2.39. Label: 9Dental prescribing on NHS Cefalexin Tablets may be prescribedOral suspension, cefalexin for reconstitution withwater, 125 mg/5 mL, net price 100 mL = £1.75;250 mg/5 mL, 100 mL = £2.15. Label: 9Dental prescribing on NHS Cefalexin Oral Suspension maybe prescribedCeporex c (Co-Pharma) ACapsules, both caramel/grey, cefalexin 250 mg, netprice 28-cap pack = £4.02; 500 mg, 28-cap pack =£7.85. Label: 9Tablets, all pink, f/c, cefalexin 250 mg, net price 28-tab pack = £4.02; 500 mg, 28-tab pack = £7.85.Label: 9Syrup, all orange, cefalexin for reconstitution withwater, 125 mg/5 mL, net price 100 mL = £1.43;250 mg/5 mL, 100 mL = £2.87; 500 mg/5 mL, 100 mL= £5.57. Label: 9Keflex c (Flynn) ACapsules, cefalexin 250 mg (green/white), net price28-cap pack = £1.46; 500 mg (pale green/dark green),21-cap pack = £1.98. Label: 9Tablets, both peach, cefalexin 250 mg, net price 28-tab pack = £1.60; 500 mg (scored), 21-tab pack =£2.08. Label: 9Suspension, cefalexin for reconstitution with water,125 mg/5 mL, net price 100 mL = 84p; 250 mg/5 mL,100 mL = £1.40. Label: 9CEFIXIMECautions see under Cefaclor; interactions: Appendix1 (cephalosporins)Contra-indications see under CefaclorRenal impairment reduce dose if estimated glomerularfiltration rate less than 20 mL/minute/1.73 m 2Pregnancy not known to be harmfulBreast-feeding manufacturer advises avoid—noinformation availableSide-effects see under CefaclorIndication and doseAcute infections due to sensitive Gram-positiveand Gram-negative bacteria, but see notesabove. By mouthChild 6 months–1 year 75 mg dailyChild 1–5 years 100 mg dailyChild 5–10 years 200 mg dailyChild 10–18 years 200–400 mg daily or 100–200 mg twice dailyUncomplicated gonorrhoea [unlicensed indication,see also Table 1, section 5.1]. By mouthChild 12–18 years 400 mg as a single doseSuprax c (Sanofi-Aventis) ATablets, f/c, scored, cefixime 200 mg. Net price 7-tabpack = £13.23. Label: 9Paediatric oral suspension, cefixime 100 mg/5 mLwhen reconstituted with water, net price 50 mL (withdouble-ended spoon for measuring 3.75 mL or 5 mLsince dilution not recommended) = £10.53, 100 mL =£18.91. Label: 9CEFOTAXIMECautions see under Cefaclor; interactions: Appendix1 (cephalosporins)Contra-indications see under CefaclorRenal impairment usual initial dose, then use halfnormal dose if estimated glomerular filtration rate lessthan 5 mL/minute/1.73 m 2Pregnancy not known to be harmfulBreast-feeding present in milk in low concentration,considered compatible with breast-feedingSide-effects see under Cefaclor; rarely arrhythmiasfollowing rapid injection reportedIndication and doseInfections due to sensitive Gram-positive andGram-negative bacteria, surgical prophylaxis,Haemophilus epiglottitis and meningitis (Table1, section 5.1) see also notes above. By intramuscular or by intravenous injection orintravenous infusionNeonate under 7 days 25 mg/kg every 12 hours;dose doubled in severe infection and meningitisNeonate 7–21 days 25 mg/kg every 8 hours;dose doubled in severe infection and meningitisNeonate 21–28 days 25 mg/kg every 6–8 hours;dose doubled in severe infection and meningitis