Table 4. Selection of Antimicrobial Therapy for Specific Pathogens (continued)
Pathogen
S. aureus, methicillin susceptible (combination therapy not well-studied)
Parenteral Therapy
Preferred: • Cefazolin (150 mg/kg/day div q8h) or
• Semisynthetic penicillin, eg, oxacillin (150-200 mg/kg/day div q6-8h)
Alternatives: • Clindamycina (40 mg/kg/day div q6-8h) or
S. aureus, methicillin resistant, susceptible to clindamycin (combination therapy not well-studied)
S. aureus, methicillin resistant, resistant to clindamycin (combination therapy not well-studied)
Haemophilus influenza typeable (A-F) or nontypeable
• Vancomycin (40-60 mg/kg/day div q6-8h)
Preferred: • Vancomycin (40-60 mg/kg/day div q6-8h or dosing to achieve an AUC/MIC ratio of > 400) or
• Clindamycin (40 mg/kg/day div q6-8h)
Alternatives: • Linezolid (30 mg/kg/day div q8h for children < 12 y and 20 mg/kg/day div q12h for children ≥ 12 y)
Preferred: • Vancomycin (40-60 mg/kg/day div q6-8h or dosing to achieve an AUC/MIC ratio of > 400)
Alternatives: • Linezolid (30 mg/kg/day div q8h for children < 12 y and 20 mg/kg/day div q12h for children ≥ 12 y)
Preferred: • If β-lactamase negative: ampicillin IV (150-200 mg/kg/day div q6h) or
• If β-lactamase producing: ceftriaxone (50-100 mg/kg/day div q12-24h) or cefotaxime (150 mg/kg/day div q8h)
Alternatives: • Ciprofloxacin IV (30 mg/kg/day div q12h) or
• Levofloxacin IV (16-20 mg/kg/day div q12h 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)
(Step-Down Therapy or Mild Infection)
Oral Therapy
Preferred: • Cephalexin PO (75-100 mg/kg/day div tid or qid)
Alternative: • Clindamycin POa (30-40 mg/kg/day div tid or qid)
Preferred: • Clindamycin PO (30-40 mg/kg/day div tid or qid)
Alternatives: • Linezolid PO (30 mg/kg/day div tid for children < 12 y and 20 mg/kg/day div bid for children ≥ 12 y)
Preferred: • Linezolid PO (30 mg/kg/day div tid for children < 12 y and 20 mg/kg/day div bid for children ≥ 12 y)
Alternatives: • None; entire treatment course with parenteral therapy may be required
Preferred: • If β-lactamase negative: amoxicillin (75-100 mg/kg/day div tid) or
• If β-lactamase producing: amoxicillin/clavulanate (amox component, 45 mg/kg/day div tid or 90 mg/kg/day div bid)
Alternatives: • Cefdinir, cefixime, cefpodoxime, or ceftibuten
Continued on next page. 9
