Intra-abdominal infections (including peritonitis)
Give antibiotics for 48-72 hours and then review.
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.
Alternatives: 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. Review once microbiology results available.
metronidazole IV dosing:
|
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
AND metronidazole iv see dosing table below
Consider adding vancomycin iv
For MRSA positive patients: ADD vancomycin iv. Review once microbiology results available.
metronidazole IV dosing:
|
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 |
* Note: Ciprofloxacin may induce convulsions in patients with or without a history of convulsions – use with caution
Also Note: If patient is prescribed ciprofloxacin ensure that the patient is given the Fluoroquinolone MHRA patient information leaflet.
For more information about MHRA safety alerts and patient or carer counselling See Fluoroquinolone antibiotics - paediatric position statement