Paediatric
Open fracture, on presentation in Emergency Dept
Give antibiotics for 3 days or until definitive closure if earlier.
Preferred
co-amoxiclav 30mg/kg (Max 1.2g) iv TDS (BD if 1-2 months old)
For MRSA positive patients: ADD vancomycin iv
Alternative
For penicillin allergy (non-severe)
ceftriaxone 50mg/kg (Max 2g) iv OD
For MRSA positive patients: ADD vancomycin iv
For penicillin allergy (severe)
clindamycin 6mg/kg (Max 600mg) iv QDS
AND
gentamicin 7mg/kg iv OD (Max 560mg)
For MRSA positive patients: ADD vancomycin iv if not susceptible to clindamycin