Prevention
Table 4. Selection of Antimicrobial Therapy for Specific Pathogens (continued)
Pathogen
S. pneumoniae resistant to penicillin with MIC values ≥ 4.0 mcg/mL
Parenteral Therapy
Preferred: • Ceftriaxone (100 mg/kg/day div q12-24h)
(Step-Down Therapy or Mild Infection)
Oral Therapy
Preferred: • Levofloxacin PO (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), if susceptible or
• Linezolid PO (30 mg/kg/day div tid for children < 12 y and 20 mg/kg/day div bid for children ≥ 12 y)
Alternatives: • Ampicillin (300-400 mg/kg/day div q6h)
• Levofloxacin (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) or
Alternative: • Clindamycin POa (30-40 mg/kg/day div tid)
May also be effective: • Clindamycina (40 mg/kg/day div q6-8h) or
Group A Streptococcus
• Linezolid (30 mg/kg/day div q8h for children < 12 y and 20 mg/kg/day div q12h for children ≥ 12 y)
• Vancomycin (40-60 mg/kg/day div q6-8h)
Preferred: • Intravenous penicillin (100,000-250,000 units/kg/day div q4-6h) or
• Ampicillin (200 mg/kg/day div q6h)
Alternatives: • Ceftriaxone (50-100 mg/kg/day div q12-24h) or
• Cefotaxime (150 mg/kg/day div q8h) May also be effective:
• Clindamycin, if susceptible (40 mg/kg/day div q6-8h) or
8
• Vancomycinb (40-60 mg/kg/day div q6-8h)
Preferred: • Amoxicillin (50-75 mg/kg/day div bid) or
• Penicillin V (50-75 mg/kg/day div tid or qid)
Alternative: • Clindamycin POa (40 mg/kg/day div tid)
