This is a follow-up post to the Refresher: Why use anti-infectives?
A number of dentists inquired about the pediatric doses for the anti-infectives mentioned in the post. Sources of information: Lexicomp and e-Therapeutics.ca
Amoxicillin
- Children ≤3 months: Oral: 20-30 mg/kg/day divided every 12 hours
- Children >3 months and <40 kg: Oral: 20-100 mg/kg/day in divided doses every 8-12 hours
- Children >3 months and ≥40 kg: Refer to adult dosing.
- Children ≥12 years: Oral: Extended-release tablet: 775 mg once daily
Amoxicillin and Clavulanate
- Susceptible infections: Infants <3 months: Oral: 30 mg/kg/day divided every 12 hours using the 125 mg/5 mL suspension
- Mild-to-moderate infections: Children ≥3 months and <40 kg: Oral: 25 mg/kg/day divided every 12 hours or 20 mg/kg/day divided every 8 hours
- Children >40 kg: Refer to adult dosing.
Cephalexin
- Usual dose: Children >1 year: Oral: Dosing range: 25-100 mg/kg/day in divided doses every 6-8 hours (maximum: 4 g/day)
- Severe infections: Children: Oral: 50-100 mg/kg/day in divided doses every 6-8 hours
Calrithromycin
Sinusitis, bronchitis, skin infections: Oral: 7.5 mg/kg/dose every 12 hours for 10 days
Clindamycin
Infants and Children:
- Oral: 8-40 mg/kg/day in 3-4 divided doses; Manufacturer’s labeling: 8-20 mg/kg/day (as hydrochloride) or 8-25 mg/kg/day (as palmitate) in 3-4 divided doses; minimum dose of palmitate: 37.5 mg 3 times daily
- I.M., I.V.: Manufacturer’s labeling: 20-40 mg/kg/day in 3-4 divided doses
Doxycycline
Usual dosage range:
- Children >8 years (≤45 kg): Oral, I.V.: 2-5 mg/kg/day in 1-2 divided doses, not to exceed 200 mg/day
- Children >8 years (>45 kg): Oral, I.V.: Refer to adult dosing.
Erythromycin
Usual dosage range: Infants and Children:
Oral:
- Base: 30-50 mg/kg/day in 2-4 divided doses; maximum: 2 g daily
- Ethylsuccinate: 30-50 mg/kg/day in 2-4 divided doses; maximum: 3.2 g daily
- Stearate: 30-50 mg/kg/day in 2-4 divided doses; maximum: 2 g daily
- I.V.: Lactobionate: 15-50 mg/kg/day divided every 6 hours, not to exceed 4 g daily
- Mild/moderate infection: Oral: 30-50 mg/kg/day in divided doses every 6-12 hours
Metronidazole
Children ≥1 month of age: 15–35 mg/kg/day po in 3 divided doses.
Penicillin V Potassium
- Adults and Children >12 Years: 1-4 g daily in 3 to 4 divided doses.
- Children <12 Years: 25-100 mg/kg/day in 3 to 4 divided doses, maximum 3 g/day.
- Treatment of Group A beta-hemolytic streptococcal infections may be dosed every 12 hours for adults and children.
Nystatin Oral Suspension: Oral candidiasis
- Infants: 200,000 units 4 times/day or 100,000 units to each side of mouth 4 times/day; paint suspension into recesses of the mouth
- Children: 400,000-600,000 units 4 times/day; swish in the mouth and retain for as long as possible (several minutes) before swallowing
Fluconazole
Usual dosage range: Oral, I.V: Loading dose: 6-12 mg/kg/dose; maintenance: 3-12 mg/kg/dose once daily; duration and dosage depend on location and severity of infection
Itraconazole
Candidiasis:
- Oropharyngeal: Oral solution: 2.5 mg/kg/dose twice daily (maximum: 200 mg/day [400 mg/day if fluconazole-refractory]) for 7-14 days
- Esophageal: Oral solution: 5 mg/kg/day once daily or divided twice daily for 4-21 days
Ketoconazole
Fungal infections: Children ≥2 years: Oral: 3.3-6.6 mg/kg once daily
Do you have any particular question on this topic? Do you have any comments or suggestions? Email us at oasisdiscussions@cda-adc.ca
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