BNF for Children 2011-2012

BNFC 2011–2012 5.1.11 Metronidazole 295secretions coloured orange-red; thrombophlebitisreported if infusion used for prolonged periodLicensed use not licensed for use in children forpruritus due to cholestasisIndication and doseTuberculosis, in combination with other drugssee notes aboveProphylaxis of meningococcal meningitis andHaemophilus influenzae (type b) infection Table2, section 5.1Brucellosis, legionnaires disease, serious staphylococcalinfections, in combination withother antibacterials. By mouth or by intravenous infusionNeonates 5–10 mg/kg twice dailyChild 1 month–1 year 5–10 mg/kg twice dailyChild 1–18 years 10 mg/kg (max. 600 mg) twicedailyPruritus due to cholestasis. By mouthChild 1 month–18 years 5–10 mg/kg (max.600 mg) once dailyAdministration Displacement value may be significant,consult local reconstitution guidelines; reconstitutewith solvent provided. May be further dilutedwith glucose 5% or sodium chloride 0.9% to a finalconcentration of 1.2 mg/mL. Infuse over 2–3 hours.Rifampicin (Non-proprietary) ACapsules, rifampicin 150 mg, net price 100 = £20.82;300 mg, 100 = £46.21. Label: 8, 14, 22, counselling,see contact lenses aboveRifadin c (Sanofi-Aventis) ACapsules, rifampicin 150 mg (blue/red), net price100-cap pack = £18.32; 300 mg (red), 100-cap pack =£36.63. Label: 8, 14, 22, counselling, see contactlenses aboveSyrup, red, rifampicin 100 mg/5 mL (raspberry-flavoured).Net price 120 mL = £3.56. Label: 8, 14, 22,counselling, see contact lenses aboveExcipients include sucroseIntravenous infusion, powder for reconstitution, rifampicin.Net price 600-mg vial (with solvent) = £7.67Electrolytes Na + < 0.5 mmol/vialRimactane c (Sandoz) ACapsules, rifampicin 150 mg (red), net price 60-cappack = £11.35; 300 mg (red/brown), 60-cap pack =£22.69. Label: 8, 14, 22, counselling, see contactlenses aboveCombined preparationsSee notes aboveRifater c (Sanofi-Aventis) ATablets, pink, s/c, rifampicin 120 mg, isoniazid 50 mg,pyrazinamide 300 mg. Net price 100-tab pack =£21.95. Label: 8, 14, 22, counselling, see contactlenses aboveRifinah c 150/100 (Sanofi-Aventis) ATablets, pink, s/c, rifampicin 150 mg, isoniazid100 mg, net price 84-tab pack = £15.91. Label: 8, 14,22, counselling, see contact lenses aboveNote Some stock packaged as Rifinah 150 or Rifinah 100/150Rifinah c 300/150 (Sanofi-Aventis) ATablets, orange, s/c, rifampicin 300 mg, isoniazid150 mg, net price 56-tab pack = £21.02. Label: 8, 14,22, counselling, see contact lenses aboveNote Some stock packaged as Rifinah 300 or Rifinah 150/300STREPTOMYCINCautions see under Aminoglycosides, section 5.1.4;measure plasma-concentration in renal impairment;interactions: Appendix 1 (aminoglycosides)Contra-indications see under Aminoglycosides, section5.1.4Renal impairment see under Aminoglycosides, section5.1.4Pregnancy see under Aminoglycosides, section 5.1.4Side-effects see under Aminoglycosides, section5.1.4; also hypersensitivity reactions, paraesthesia ofmouthPharmacokinetics one-hour (‘peak’) concentrationshould be 15–40 mg/litre; pre-dose (‘trough’) concentrationshould be less than 5 mg/litre (less than1 mg/litre in renal impairment)Licensed use not licensed for use in childrenIndication and doseTuberculosis, resistant to other treatment, incombination with other drugs. By deep intramuscular injectionChild 1 month–18 years 15 mg/kg (max. 1 g)once dailyAdjunct to doxycycline in brucellosis, expertadvice essential. By deep intramuscular injectionChild 1 month–18 years 5–10 mg/kg every 6hours; total daily dose may alternatively be givenin 2–3 divided dosesStreptomycin Sulphate (Non-proprietary) AInjection, powder for reconstitution, streptomycin (assulphate), net price 1-g vial = £8.25Available as an unlicensed preparation from UCB Pharma5.1.10 Antileprotic drugsClassification not used in BNF for Children.5.1.11 MetronidazoleMetronidazole is an antimicrobial drug with high activityagainst anaerobic bacteria and protozoa. It is alsoused for surgical and gynaecological sepsis in which itsactivity against colonic anaerobes, especially Bacteroidesfragilis, is important. Metronidazole by mouthis effective for the treatment of Clostridium difficileinfection (see also section 1.5); it can be given by intravenousinfusion if oral treatment is inappropriate.5 Infections