Antibiotic | Dose |
For patients without a history of recurrent otitis media or recent antibiotic therapy | |
Ampicillin-sulbactam | 150 to 200 mg/kg per day IV divided every 6 or 8 hours (maximum 2 g per dose) |
For patients with a history of recurrent otitis media (last episode within 6 months) or recent antibiotic therapy | |
For patients without penicillin allergy | |
Piperacillin-tazobactam* | 300 mg/kg per day of piperacillin component IV divided every 6 or 8 hours (maximum daily dose 16 g of piperacillin component) |
For patients with potential severe hypersensitivity (ie, anaphylaxis) to beta-lactam antibiotics (eg, penicillin, cephalosporin)Δ (2 agents) | |
Vancomycin*¶ or | 15 mg/kg per dose IV every 6 hours (maximum 1 g per dose) |
Linezolid | 10 mg/kg per dose IV every 8 hours for children <12 years old and every 12 hours for children ≥12 years old (maximum 600 mg per dose) |
plus | |
Metrodinazole | 7.5 mg/kg per dose IV every 8 hours (maximum daily dose 4 g) |
For patients with non-anaphylactic hypersensitivity to penicillins (2 agents) | |
Ceftazidime* or | 50 mg/kg per dose IV every 8 hours (maximum 2 g per dose) |
Cefepime* | 50 mg/kg per dose IV every 8 hours (maximum 2 g per dose) |
plus | |
Metronidazole | 7.5 mg/kg per dose IV every 8 hours (maximum daily dose 4 g) |
IV: intravenous; ESBL: extended-spectrum beta-lactamase.
* Dose modification for renal insufficiency is necessary. Refer to UpToDate drug information topic.
¶ Monitor blood levels to insure efficacy and avoid toxicity.
Δ Rapid desensitization and use of first-line agents may be preferred if feasible.Do you want to add Medilib to your home screen?