By John S. Bradley MD, John D. Nelson MD Emeritus
Read Online or Download 2010-2011 Nelson's Pocket Book of Pediatric Antimicrobial Therapy PDF
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Extra info for 2010-2011 Nelson's Pocket Book of Pediatric Antimicrobial Therapy
AIII) 21 d. CT scan to confirm cure. 5 mg/kg/day IM, IV, or amikacin 15–20 mg/kg/ alternatives (no clinical data). Very poor outcomes. day IM, IV div q8h x 10–14 d (AIII) Ceftriaxone 50 mg/kg q24h IV, IM (AIII) Treatment course x 10–14 d – Staphylococcal Vancomycin 40 mg/kg/day IV div q8h pending susceptibility testing; oxacillin 150 mg/kg/day IV div q6h if susceptible (AIII) – Empiric therapy following Vancomycin 40 mg/kg/day IV div q8h AND ceftazidime open globe injury 150 mg/kg/day IV div q8h (AIII) Endophthalmitis56,57 NOTE: Subconjunctival/subtenon antibiotics usually needed; steroids commonly used; Refer to ophthalmologist; vitrectomy may be necessary for requires anterior chamber or vitreous tap for microbiological diagnosis advanced endophthalmitis Dacryocystitis No antibiotic usually needed; oral therapy for more Warm compresses; may require surgical probing of symptomatic infection, based on Gram stain and nasolacrimal duct culture of pus; topical therapy as for conjunctivitis may be helpful Conjunctivitis, herpetic54,55 Trifluridine 1% ophth soln OR acyclovir 3% ophth Refer to ophthalmologist.
If more than 1 day of therapy is missed, the entire course is restarted. Reliable follow-up important if only a single dose of benzathine penicillin given Evaluation to determine type and duration of therapy: CSF analysis (VDRL, cell count, protein) CBC and platelet count. Other tests as clinically indicated, including long-bone radiographs, chest radiograph, liver function tests, cranial ultrasound, ophthalmologic exam, and hearing test (auditory brainstem response) Proven or highly probable disease: (1) abnormal physical exam; (2) serum quantitative non treponemal serologic titer that is 4-fold higher than the mother’s titer; or (3) a positive darkfield or fluorescent antibody test of body fluid(s).
E. OROPHARYNGEAL INFECTIONS Sinusitis, acute Same antibiotic therapy as for AOM (amoxicillin 90 mg/ For more severe symptoms, use high-dosage amox/clav to (H influenzae non–type b, kg/day PO div bid) (BIII). indd 42 Pharyngitis Amoxicillin 50–75 mg/kg/day PO, either once daily, bid Amoxicillin displays better gastrointestinal absorption (group A streptococcus) or tid x 10 d OR penicillin V 50–75 mg/kg/day PO div than oral phenoxymethyl penicillin; the suspension is 7,91–93 tonsillopharyngitis bid or tid, OR benzathine penicillin 600,000 units IM better tolerated.