Lymphadenitis (Severe)
This guideline refers to severe pyogenic infection, so would not include chronic cold abscess type disease, such as Bartonella or mycobacteria. In these cases Paediatric ID should be consulted.
Treat for 5 days.
Preferred
co-amoxiclav 30mg/kg (Max 1.2g) iv TDS (BD if 1-2 months old)
Stepdown to oral therapy when clinically improving.
|
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
For penicillin allergy (severe)
clindamycin 10mg/kg (Max 600mg) iv QDS
For MRSA positive patients:
Add vancomycin iv. Review once microbiology results available.