Paediatric
Mastoiditis
If there is intracranial involvement, refer to Brain abscess guideline
Treat for 14 days.
Preferred
co-amoxiclav 30mg/kg (Max 1.2g) iv TDS (BD if 1-2 months old)
oral switch: co-amoxiclav po (see dosing table)
| 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 |
Alternative
For penicillin allergy (non-severe):
ceftriaxone 80mg/kg (Max 4g) iv OD
oral switch: cefalexin 25mg/kg (Max 1g) po TDS
For penicillin allergy (severe) or MRSA positive patients:
co-trimoxazole 18mg/kg (Max 960mg) iv BD can be increased to 27mg/kg (Max 1.44g) iv BD in severe infection
Oral switch: co-trimoxazole (see dosing table below)
| Age | co-trimoxazole oral dose |
| 6 Weeks to 5 years | 24mg/kg BD |
| 6 Years to 11 years | 24mg/kg (Max 960mg) BD |
| 12 years to 17 years | 960mg BD |