By John S. Bradley MD, John D. Nelson MD Emeritus
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Extra info for 2010-2011 Nelson's Pocket Book of Pediatric Antimicrobial Therapy
In general, the neonatal exposure is welltolerated. While maternal treatment with sulfa-containing antibiotics should be approached with caution in the breastfed jaundiced or ill neonate, no symptoms have been associated with maternal treatment with amoxicillin, cefazolin, cefotaxime, ceftazidime, ceftriaxone, ciprofloxacin, clindamycin, erythromycin, ethambutol, fluconazole, gentamicin, isoniazid, rifampin, (used for <3 weeks). Metronidazole seems safe, but may impart a metallic taste to breast milk.
Other tests as clinically indicated, including long-bone radiographs, chest radiograph, liver function tests, cranial ultrasound, ophthalmologic exam, and hearing test (auditory brainstem response), If no clinical manifestations of disease, the CSF exam is normal, and the CSF VDRL test result is negative, some specialists would treat with up to 3 weekly doses of benzathine penicillin G, 50,000 U/kg IM. Aqueous crystalline penicillin G 200,000–300,000 units/kg/day IV div q4–6 hr for 10 d Syphilis, congenital (>1 month of age)87 Recommended Therapy for Selected Newborn Conditions — 25 1/28/10 3:08 PM 26 B.
Single dose (AII) Once daily amoxicillin dosage: for children >3 years of For penicillin-allergic children: erythromycin (estolate at age and <40 kg: 750 mg once daily; for those >40 kg, 20–40 mg/kg/day PO div bid to qid; or ethylsuccinate 1,000 mg once daily. 94 Peritonsillar cellulitis or Clindamycin 30 mg/kg/day PO, IV, IM div q8h AND Consider incision and drainage for abscess abscess cefotaxime 150 mg/kg/day IV div q8h (BIII) Alternatives: meropenem or imipenem; PIP/TAZO; amox/ (group A streptococcus with clav for convalescent oral therapy (BIII) No useful data on benefits of steroids mixed oral flora)89,90 Empiric: meropenem 60 mg/kg/day div q8h (or 120 Anecdotal reports suggest metronidazole may be Lemierre syndrome (Fusobacterium necrophorum)88 mg/kg/day div q8h for CNS metastatic foci) (AIII) OR effective for apparent failures with other agents.
2010-2011 Nelson's Pocket Book of Pediatric Antimicrobial Therapy by John S. Bradley MD, John D. Nelson MD Emeritus