Pediatric Primary Care (143 page)

Impetigo, otitis media, sinusitis: Children 3 mos-12 years: 30 mg/kg/day PO in 2 divided doses for 10 days. Max 1 g/day. Tablets: 250 mg PO bid for 10 days.

Susceptible infections: Neonates: 20-100 mg/kg/day IV in divided doses q12h. Children older than 3 months: 50-100 mg/kg/day IV/IM divided q6-8h.

Bone and joint infections: Children older than 3 mos: 150 mg/kg/day IV/IM divided q8h.

Meningitis: Children 3 months old or older: 200-240 mg/kg/day IV/IM divided q6-8h. Max 9 g/day.

Bronchitis: Adults: 250 or 500 mg PO bid for 10 days.

Gonorrhea: Adults: 1 g PO as a single dose; 1.5 g IM as a single dose with 1.5 g probenecid PO.

Gonococcal infections: Adults: 750 mg IV/IM q8h.

Pharyngitis/tonsillitis/sinusitis: Adults: 250 mg PO bid for 10 days.

Skin infections: Adults: 250-500 mg PO bid for 10 days.

Urinary tract infections: Adults: 125mg or 250 mg PO bid for 7-10 days.

Adverse Reactions

Local reactions at IV/IM site; diarrhea, abdominal cramping, nausea; oral and vaginal candidiasis.

Implications

  Adjust dose for renal impairment.

  Take antibiotic for full length of treatment.

CEPHALEXIN HYDROCHLORIDE–FIRST-GENERATION CEPHALOSPORIN ANTIBIOTIC

Brand Name

Keftab, Keflex, Biocef

Uses

Treat infections of respiratory tract, GI tract, skin, soft tissue, bone, joints, and otitis media caused by
Escherichia coli
and other coliform bacteria, Group A beta-hemolytic streptococci,
Klebsiella
species,
Proteus mirabilis, Streptococcus pneumoniae
, and staphylococci.

Availability

Cephalexin hydrochloride: Tablets: 500 mg. Cephalexin monohydrate: Oral suspension: 125 mg/5 mL, 250 mg/5 mL. Tablets: 250 mg, 500 mg, 1 g. Capsules: 250 mg, 500 mg.

Indications/Routes/Dosage

Children: 25-50 mg/kg/day PO in 2 to 4 equally divided doses. Adults: 250 mg-1 g PO q6h or 500 mg q12h. Max 4 g daily. Dose can be doubled in severe infections.

Adverse Reactions

Dizziness, headache, confusion, fatigue, hallucinations, nausea, vomiting, diarrhea, pseudomembranous colitis, oral candidiasis, vaginitis, genital pruritus, interstitial nephritis, neutropenia, anemia, thrombocytopenia, arthritis, joint pain, rash, urticaria, hypersensitivity reactions.

Implications

  Take with food or milk.

  There is a possibility of cross-sensitivity with penicillin and other beta-lactam antibiotics.

  Adjust dose for renal impairment.

  Avoid using with aminoglycosides, increases risk of nephrotoxicity.

CETIRIZINE–ANTIHISTAMINE

Brand Name

Zyrtec

Uses

Rhinitis, allergic symptoms.

Availability

Syrup: 5 mg/5 mL. Tablets: 5 mg, 10 mg.

Indications/Routes/Dosage

Child 2-6 years: 2.5 mg daily may increase to 5 mg daily or 2.5 mg bid.

Child older than 6 years, adult: 5-10 mg daily.

Zyrtec D (5 mg with 120 mg pseudoephedrine) once bid.

Adverse Reactions

Thickening of bronchial secretions, dry mouth, headache, drowsiness.

Implications

  Avoid driving if drowsiness occurs; use sunscreen when in sunlight.

  Notify provider of difficulty voiding.

CIPROFLOXACIN HYDROCHLORIDE–FLUOROQUINOLONE ANTI-INFECTIVE

Brand Name

Cipro

Uses

Treat conjunctival keratitis, keratoconjunctivitis, corneal ulcers, blepharitis, dacryocystitis, blepharoconjunctivitis.

Availability

Ophthalmic: 0.03%; Otic (Ciprodex).

Indications/Routes/Dosage

Conjunctivitis: 1-2 drops q2h for 2 days, then q4h next 5 days.

Corneal ulcer: 2 drops q15min for 6h, then 2 drops q30min remainder first day; 2 drops q1h second day; then q4h days 3-14.

Otic: older than 6 months, 4 drops in ear bid for 7 days.

Adverse Reactions

Ophthalmic: Sensitization may contraindícate later systemic use of ciprofloxacin.

Implications

  Tilt patient's head back, put drops in conjunctival sac.

  Do not use ophthalmic solution as injection.