BNF for Children 2011-2012

282 5.1.5 Macrolides BNFC 2011–20125 InfectionsLyme disease (see also section 5.1.1.3). By mouthChild 1 month–12 years 7.5 mg/kg (max.500 mg) twice daily for 14–21 daysChild 12–18 years 500 mg twice daily for 14–21daysHelicobacter pylori eradication section 1.3Prevention of pertussis Table 2, section 5.1Administration for intermittent intravenous infusiondilute reconstituted solution further in Glucose 5% orSodium chloride 0.9% to a concentration of 2 mg/mL;give into large proximal vein over 60 minutesClarithromycin (Non-proprietary) ATablets, clarithromycin 250 mg, net price 14-tab pack= £3.17; 500 mg, 14-tab pack = £4.10. Label: 9Dental prescribing on NHS Clarithromycin Tablets may beprescribedOral suspension, clarithromycin for reconstitutionwith water 125 mg/5 mL, net price 70 mL = £6.82;250 mg/5 mL, 70 mL = £13.63. Label: 9Dental prescribing on NHS Clarithromycin Oral Suspensionmay be prescribedIntravenous infusion, powder for reconstitution,clarithromycin; net price 500-mg vial = £10.31Klaricid c (Abbott) ATablets, both yellow, f/c, clarithromycin 250 mg, netprice 14-tab pack = £6.30; 500 mg, 14-tab pack =£10.17, 20-tab pack = £14.54. Label: 9Paediatric suspension, clarithromycin for reconstitutionwith water 125 mg/5 mL, net price 70 mL =£4.73, 100 mL = £8.14; 250 mg/5 mL, 70 mL = £9.46.Label: 9Granules, clarithromycin 250 mg/sachet, net price14-sachet pack = £11.68. Label: 9, 13Intravenous infusion, powder for reconstitution,clarithromycin. Net price 500-mg vial = £9.45Electrolytes Na + < 0.5 mmol/500-mg vialKlaricid XL c (Abbott) ATablets, m/r, yellow, clarithromycin 500 mg, net price7-tab pack = £6.46, 14-tab pack = £12.71. Label: 9, 21,25Dose. By mouthChild 12–18 years 500 mg once daily (doubled in severeinfections) for 7–14 daysIndication and doseSusceptible infections in patients with penicillinhypersensitivity, oral infections (seenotes above), campylobacter enteritis, respiratory-tractinfections (including Legionellainfection), skin infections, chlamydial ophthalmia,prevention and treament of pertussis (seealso Table 2, section 5.1). By mouthNeonate 12.5 mg/kg every 6 hoursChild 1 month–2 years 125 mg 4 times daily;dose doubled in severe infectionsChild 2–8 years 250 mg 4 times daily; dosedoubled in severe infectionsChild 8–18 years 250–500 mg 4 times daily; dosedoubled in severe infectionsNote Total daily dose may be given in two divided doses. By intravenous infusionNeonate 10–12.5 mg/kg every 6 hoursChild 1 month–18 years 12.5 mg/kg (max. 1 g)every 6 hoursEarly syphilis. By mouthChild 12–18 years 500 mg 4 times daily for 14daysUncomplicated genital chlamydia, non-gonococcalurethritis, pelvic inflammatory disease(see also Table 1, section 5.1). By mouthChild 1 month–2 years 12.5 mg/kg 4 times dailyfor 14 daysChild 2–12 years 250 mg twice daily for 14 daysChild 12–18 years 500 mg twice daily for 14 daysLyme disease (see also section 5.1.1.3). By mouthChild 1 month–18 years 12.5 mg/kg (max.500 mg) 4 times daily for 14–21 daysProphylaxis against pneumococcal infectionTable 2, section 5.1Gastric stasis section 1.2ERYTHROMYCINCautions see notes above; neonate under 2 weeks (riskof hypertrophic pyloric stenosis); acute porphyria(section 9.8.2); interactions: Appendix 1 (macrolides)Hepatic impairment may cause idiosyncratichepatotoxicityRenal impairment reduce dose in severe renalimpairment (ototoxicity)Pregnancy not known to be harmfulBreast-feeding only small amounts in milk—notknown to be harmfulSide-effects see notes above; also myasthenia-likesyndromeAcne vulgaris section 13.6Diphtheria prophylaxis Table 2, section 5.1Prevention of group A streptococcal infectionTable 2, section 5.1Administration Dilute reconstituted solution furtherin glucose 5% (neutralised with Sodium bicarbonate)or sodium chloride 0.9% to a concentration of 1–5 mg/mL; give over 20–60 minutesConcentration of up to 10 mg/mL may be used influid-restriction if administered via a central venouscatheter