Prevention
Table 4. Selection of Antimicrobial Therapy for Specific Pathogens (continued)
Pathogen Parenteral Therapy
M. pneumoniae Preferred: • Azithromycin IV (10 mg/kg on days 1 and 2 of therapy; transition to oral therapy if possible)
Alternatives: • Erythromycin lactobionate IV (20 mg/kg/day div q6h) or
• Levofloxacin (16-20 mg/kg/day div q12h; max daily dose, 750 mg)
(Step-Down Therapy or Mild Infection)
Oral Therapy
Preferred: • Azithromycin (10 mg/kg on day 1, followed by 5 mg/kg once daily on days 2-5)
Alternatives: • Clarithromycin (15 mg/kg/day div bid) or
• Erythromycin PO (40 mg/kg/day div qid)
• For children > 7 y: doxycycline (2-4 mg/kg/day div bid)
• For adolescents with skeletal maturity: levofloxacin (500 mg once daily) or moxifloxacin (400 mg once daily)
Chlamydia trachomatis or C. pneumoniae
Preferred: • Azithromycin (10 mg/kg on days 1 and 2 of therapy; transition to oral therapy if possible)
Alternatives: • Erythromycin lactobionate IV (20 mg/kg/day div q6h) or
• Levofloxacin (16-20 mg/kg/day div bid for children 6 mo to 5 y and 8-10 mg/kg once daily for children 5 to 16 y; max daily dose, 750 mg)
Preferred: • Azithromycin (10 mg/kg on day 1, followed by 5 mg/kg once daily on days 2-5)
Alternatives: • Clarithromycin (15 mg/kg/day div bid) or
• Erythromycin PO (40 mg/kg/day div qid)
• For children > 7 y: doxycycline (2-4 mg/kg/day div bid)
• For adolescents with skeletal maturity: levofloxacin (500 mg once daily) or moxifloxacin (400 mg once daily)
a Clindamycin resistance appears to be increasing in certain geographic areas among S. pneumoniae and S. aureus infections.
b For β-lactam–allergic children.
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