By John S. Bradley MD, John D. Nelson MD Emeritus, Dr. David W Kimberlin MD FAAP, Dr. John A.D. Leake MD MPH, Dr. Paul E Palumbo MD, Dr. Jason Sauberan PharmD, Dr. William J Steinbach
New twentieth Edition! This bestselling and normal source on pediatric antimicrobial treatment offers immediate entry to trustworthy, up to date options for therapy of all infectious ailments in young children.
For each one illness, the authors offer a statement to aid wellbeing and fitness care prone opt for the simplest of all antimicrobial choices. Drug descriptions disguise all antimicrobial brokers to be had this day and contain whole information regarding dosing regimens. according to growing to be matters approximately overuse of antibiotics, this system comprises instructions on while to not prescribe antimicrobials.
Practical, evidence-based concepts from the specialists in antimicrobial remedy:
Developed via unusual editorial board
Designed if you look after little ones and are confronted with judgements each day
Includes remedy of parasitic infections and tropical medicine.
Updated tests in regards to the power of the advice and the point of proof for therapy thoughts for significant infections
Anti-infective drug directory, whole with formulations and dosages
Antibiotic treatment for overweight children
Antimicrobial prophylaxis/prevention of symptomatic infection
Maximal grownup dosages and better dosages of a few antimicrobials general in children
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Additional info for 2014 Nelson's Pediatric Antimicrobial Therapy
Normal physical exami- No treatment nation, serum quantitative non-treponemal serologic titer ≤maternal titer, and the mother’s treatment was adequate before pregnancy Aqueous crystalline penicillin G 200,000–300,000 units/kg/day IV div q4–6h for 10 days (AII) No evaluation required. Some experts would not treat but provide close serologic follow-up. Benzathine penicillin G 50,000 units/kg/dose IM in a single –– Normal physical dose (AIII) examination, serum quantitative non- treponemal serologic titer ≤maternal titer: mother treated adequately during pregnancy and >4 wk before delivery; no evidence of reinfection or relapse in mother 2014 Nelson’s Pediatric Antimicrobial Therapy — 29 5 3/13/14 2:54 PM Sulfadiazine 100 mg/kg/day PO div q12h AND pyrimethamine 2 mg/kg PO daily for 2 days (loading dose), then 1 mg/kg PO q24h for 2–6 mo, then 3 times weekly (M-W-F) up to 1 y (AII) Folinic acid (leukovorin) 10 mg 3 times weekly (AII) Initial empiric therapy with ampicillin AND gentamicin; OR ampicillin AND cefotaxime pending culture and susceptibility test results for 7–10 days Cefotaxime IV, IM OR, in the absence of renal or perinephric abscess, gentamicin IV, IM for 7–10 days (AII) Ampicillin IV, IM for 7 days for cystitis, may need 10–14 days for pyelonephritis, add gentamicin until cultures are sterile (AIII); for ampicillin resistance, use vancomycin, add gentamicin until cultures are sterile.
S aureus coverage is only fair with amox/clav, ticar/clav, pip/tazo. For penicillin allergy, ciprofloxacin (for Pasteurella) plus clindamycin (BIII). Antimicrobial Therapy According to Clinical Syndromes Standard: cephalexin 50–75 mg/kg/day PO div tid OR amox/clav 45 mg/kg/day PO div tid (CII) CA-MRSA: clindamycin 30 mg/kg/day PO div tid OR TMP/SMX 8 mg/kg/day of TMP PO div bid; for 5–7 days (CIII) Bullous impetigo1–3,5–7 (usually S aureus, including CA-MRSA) Gas gangrene (see Necrotizing fasciitis) Amox/clav 45 mg/kg/day PO div tid (amox/clav 7:1; see Chapter 1, Aminopenicillins) for 5–10 days (AII); for hospitalized children, use ticar/clav 200 mg ticarcillin/kg/day div q6h OR ampicillin and clindamycin (BII).
Higher dosages may be necessary if the antibiotic does not penetrate well into the infected tissue (eg, meningitis) or if the child is immunocompromised. •• Duration of treatment should be individualized. Those recommended are based on the •• Diseases in this chapter are arranged by body systems. Consult the index for the alphabetized listing of diseases and chapters 7 through 10 for the alphabetized listing of pathogens and for uncommon organisms not included in this chapter. •• Abbreviations: ADH, antidiuretic hormone; AFB, acid-fast bacilli; amox/clav, amoxicillin/clavulanate; amp/sulbactam, ampicillin/sulbactam; AOM, acute otitis media; AST, aspartate transaminase; ALT, alanine transaminase; bid, twice daily; CA-MRSA, community-associated methicillin-resistant Staphylococcus aureus; CDC, Centers for Disease Control and Prevention; CMV, cytomegalovirus; CNS, central nervous system; CSD, cat-scratch disease; CSF, cerebrospinal fluid; CT, computed tomography; div, divided; DOT, directly observed therapy; EBV, Epstein-Barr virus; ESBL, extended spectrum beta-lactamase; ESR, erythrocyte sedimentation rate; FDA, US Food and Drug Administration; GI, gastrointestinal; HIV, human immunodeficiency virus; HSV, herpes simplex virus; HUS, hemolytic uremic syndrome; I&D, incision and drainage; IDSA, Infectious Diseases Society of America; IM, intramuscular; INH, isoniazid; IV, intravenous; IVIG, intravenous immune globulin; LFT, liver function test; LP, lumbar puncture; MRSE, methicillin-resistant Staphylococcus epidermidis; MSSA, methicillin-susceptible S aureus; MSSE, methicillin-sensitive S epidermidis; NIH, National Institutes of Health; ophth, ophthalmic; PCV7, Prevnar 7-valent pneumococcal conjugate vaccine; PCV13, Prevnar 13-valent pneumococcal conjugate vaccine; pen-R, penicillin-resistant; pen-S, penicillin-susceptible; pip/tazo, piperacillin/tazobactam; PO, oral; PPD, purified protein derivative; PZA, pyrazinamide; qd, once daily; qid, 4 times daily; qod, every other day; RSV, respiratory syncytial virus; SPAG-2, small particle aerosol generator-2; STI, sexually transmitted infection; soln, solution; ticar/clav, ticarcillin/clavulanate; tid, 3 times daily; TB, tuberculosis; TMP/SMX, trimethoprim/sulfamethoxazole; ULN, upper limit of normal; USP-NF, US Pharmacopeia–National Formulary; UTI, urinary tract infection; VDRL, Venereal Disease Research Laboratories; WBC, white blood cell.