Pneumonia

< 1 month

< 5 years

> 5 years

Immuno-compromised

First Line

Cefotaxime 50mg/kg BD under 7 days; 50mg/kg TDS 7 - 28 days

plus

Amoxicillin 60mg/kg BD under 7 days; 60mg/kg TDS 7 - 28 days

Augmentin 30mg/kg TDS
(can increase to QDS in sever infections if over 3 months old)

Augmentin 30mg/kg TDS (max 1.2g )

plus

Clarithromycin 7.5mg/kg (max 500mg) BD

Tazocin 90mg/kg (max 4.5g) TDS if < 1 month; QDS (1 month - 12yrs)

plus

Gentamicin see BNFC
plus

Clarithromycin 7.5mg/kg (max 500mg) BD

Second Line (if already treated with above >48 hrs prior to admission to PICU)

Per previous NBL result & after discussion with microbiology

Organisms

Group B Strep, S. aureus, GNB, E. Coli, listeria +/- Chlamydia

S. pneumoniae, B. pertussis, Group A strep, S. aureus (post viral) Anaerobes (abscess)

S. pneumoniae, Group A strep, S. aureus (post viral), mycoplasma Anaerobes (abscess)

S. pneumoniae,
Group A strep,
S. aureus, GNB
pseudomonas,
legionella
mycoplasma Anaerobes

Neurosurgical

Cerebral/Subdural Abscess Unknown Source

Flucloxacillin 50mg /kg
<7 days BD
7 - 21 days TDS
>21 days QDS (max 1g QDS)

plus

Ceftriaxone 80mg/kg daily (< 1 month 50mg/kg)

plus

Metronidazole
neonate 15mg/kg load, then 24 hours later 7.5mg/kg BD
> 1 month - 7.5mg/kg TDS (max 500mg)

Cerebral/Subdural Abscess Related to Otitis media

Flucloxacillin 50mg /kg
<7 days BD
7 - 21 days TDS
>21 days QDS (max 1g QDS)

plus

Ceftazidime 50mg/kg
<7 days once daily
7 - 21 days BD
>21 days TDS
Max dose 6g daily

plus

Metronidazole
neonate 15mg/kg load, then 24 hours later 7.5mg/kg BD
> 1 month - 7.5mg/kg TDS (max 500mg)

VP shunt Infection

Vancomycin see BNF-C for doasgae schedule

plus

Ceftazidime 50mg/kg
<7 days once daily
7 - 21 days BD
>21 days TDS
Max dose 6g daily

Base of Skull # with CSF leak

None

Compound skull #

Augmentin 30mg/kg TDS (BD if < 7 days old)