Colorectal surgery, complicated by perforation / faecal peritonitis
Give antibiotics for up to 5 days. If a total course of more than 5 days is needed discuss it with Paeds ID
Preferred
co-amoxiclav 30mg/kg (Max 1.2g) iv TDS (BD if 1-2 months old)
If septic add STAT dose gentamicin 7mg/kg iv (Max 560mg)
For MRSA positive patients: Add vancomycin iv. Review once microbiology results available.
Oral step down:
co-amoxiclav po see dosing table below
| Age | co-amoxiclav oral dose |
| 1 month to 11 months | 0.5mL/kg of 125mg/31mg/5mL suspension TDS |
| 1 year to 5 years | 10mLs of 125mg/31mg/5mL suspension TDS |
| 6 years to 11 years | 10mLs of 250mg/62mg/5mL suspension TDS |
| 12 years to 17 years |
One 625mg tablet TDS OR 10mLs of 250mg/62mg/5mL suspension TDS if patient cannot take tablets |
Alternatives: Penicillin allergy (non-severe)
For penicillin allergy (non-severe)
ceftriaxone 80mg/kg (Max 4g) iv OD
AND metronidazole iv see dosing table below
If septic add STAT dose gentamicin 7mg/kg iv (Max 560mg)
For MRSA positive patients: Add vancomycin iv.
metronidazole IV dosing information:
|
Age |
metronidazole IV dose |
|
1 month up to 2 months |
Loading dose 15 mg/kg (Max 500mg) iv, then (after 8 hours) 7.5 mg/kg (Max 500mg) iv TDS |
|
2 months to 17 years |
7.5mg/kg (Max 500mg) iv TDS |
Alternatives: Penicillin allergy (severe)
ciprofloxacin* 10mg/kg (Max 400mg) iv TDS * ciprofloxacin may induce convulsions in patients with or without a history of convulsions – use with caution
AND metronidazole iv see dosing table below
For MRSA positive patients: Add vancomycin iv. Review once microbiology results available.
metronidazole IV dosing information:
|
Age |
metronidazole IV dose |
|
1 month up to 2 months |
Loading dose 15 mg/kg (Max 500mg) iv, then (after 8 hours) 7.5 mg/kg (Max 500mg) iv TDS |
|
2 months to 17 years |
7.5mg/kg (Max 500mg) iv TDS |
Oral step down in non-severe and severe penicillin allergy
ciprofloxacin* 20mg/kg (max 750mg) po BD * ciprofloxacin may induce convulsions in patients with or without a history of convulsions – use with caution
AND metronidazole po
1 month: 7.5 mg/kg (Max 400mg) po BD
2 months-11 years: 7.5 mg/kg (Max 400mg) po TDS
12 years and older: 400mg po TDS