Bacterial tracheitis and epiglottitis
Consider discussion with PICU and Paediatric ID.
Treat for 5 days
Switch to oral antibiotics based on isolated pathogen and susceptibility.
Preferred
co-amoxiclav 30mg/kg (Max 1.2g) iv TDS (BD if 1-2 months old)
For MRSA positive patients: ADD vancomycin iv. Review once microbiology results available.
Alternative
For penicillin allergy (non-severe):
ceftriaxone 80mg/kg (Max 4g) iv OD
For penicillin allergy (severe):
ciprofloxacin* 10mg/kg (Max 400mg) iv TDS
AND clindamycin 10mg/kg (Max 600mg) iv QDS
For MRSA positive patients: ADD vancomycin iv. Review once microbiology results available.
* 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