Pain –
Pain – Paracetamol (oral): 15 mg/kg/dose (maximum 1 g) QID (Dose based on ideal body weight)
Pain – Ibuprofen (oral) : 10 mg/kg/dose (maximum 400 mg) Q6h
Pain – Oxycodone (oral) 0.1 mg/kg/dose (maximum 5 mg) QID
Asplenia/Hyposplenism – Antibiotic prophylaxis (Daily antibiotics) Amoxicillin 20 mg/kg (up to 250 mg) orally, daily
OR
Phenoxymethylpenicillin 250 mg(child younger than 1 year: 62.5 mg to 5 years: 125mg) orally, 12-hourly
Minimum recommended duration is:
Up to the age of 5 years in children with asplenia
- Up to the age of 5 years who are hyposplenic due to sickle cell anaemia or another congenital haemoglobinopathy
- At least 3 years after splenectomy
Croup
- Croup Mild-moderate – Dexamethasone : 0.15mg/kg 20, 23, maximum 12mg or Prednisolone (Oral) Day 1: 1mg/kg/day Day 1, then 36hours later another dose
- Croup Severe or life-threatening – Dexamethasone : 0.6mg/kg (oral/IV/IM), maximum 12mg AND
- Adrenaline (NEB) – 5 mL of undiluted 1:1000 Adrenaline nebulised with oxygen as a single dose.
Anaphylaxis – adrenaline IM – 10 mcg/kg or 0.01 mL/kg – 1:1000 (maximum 0.5 mL)
Allergic reaction – Cetirizine (Oral) (Zyrtec)
1-2 years 2.5 mg twice daily
2-6 years 5 mg once daily or 2.5mg twice daily
6-12 years 10 mg once daily or 5mg twice daily
12-18 years 10 mg once daily
Asthma – Mild – 1-5 years : 2-6 puffs Salbutamol MDI
– >6 years 12 puffs Salbutamol MDI
Otis Media – Amoxicillin 30mg/kg – BD for 5 days
Otis Media penecillin hypersensitivity:
- 3 months to 2 years: 10mg/g max 125mg BD for 5 days for 5 days
- 2 years and older 15mg/kg max 500mg BD for 5 days for 5 days
- Trimepthoprim _ Sulfamethoxazole – child 1 month or older: 4+20mg/kg – max 160-180mg, BD for 5 days
Otis Media – Persistent – Amoxicillin /clavulanic acid 22.5mg/kg BD dose for 5 days
Meningitis Contact prophylaxis – N. meningitidis
Ciprofloxacin 250 mg (5–12 years) 500 mg (≥12 years) oral single dose for 2 days
Unable to take tablets: Rifampicin 5 mg/kg ( <1 month) or 10 mg/kg (≥1 month) (max 600 mg) oral bd for 2 days
Meningitis Contact prophylaxis – H. influenzae type b: Rifampicin 20 mg/kg (600 mg) oral daily for 2 days
Threadworm (Pinworm) – Mebendazole 50 mg oral (<10 kg) 100 mg oral (≥10 kg) or Pyrantel 10 mg/kg (1 g) oral
Urinary tract infection
- >6 months of age and not sick (E. coli P. mirabilis K. oxytoca Other Gram-negatives)
- Cefalexin 33 mg/kg (500 mg) oral bd or
- Trimethoprim 4 mg/kg (150 mg) oral bd or
- Trimethoprim/Sulfamethoxazole (8/40 mg/mL) 0.5 mL/kg (20 mL) oral bd
Pertussis
- Azithromycin 10 mg/kg (500 mg) oral daily (Birth – 6 months), 10 mg/kg oral on Day 1, then 5 mg/kg (250 mg) daily (≥6 months) 5 days OR
- Clarithromycin 7.5 mg/kg (500 mg) oral bd 7 days
Pneumonia
Mild (outpatient) – Amoxicillin 30 mg/kg (1 g) oral tds – 3-5 days
Moderate (inpatient) – Amoxicillin 30 mg/kg (1 g) oral tds 5 days
Severe (≥2 of: severe respiratory distress, severe hypoxaemia or cyanosis, marked tachycardia, altered mental state OR empyema – Flucloxacillin3 50 mg/kg (2 g) IV 6H and 3rd gen cephalosporin 10 days
Tonsillitis: Group A streptococci (GAS) – Features of GAS infection in child ≥4 years AND high-risk group (Indigenous Australians , Maori and Pacific Islander, Personal history of rheumatic fever or rheumatic heart disease, Family history of rheumatic fever or rheumatic heart disease, Immunosuppressed) or suppurative complications:
- Phenoxymethylpenicillin (Penicillin V) 250 mg oral bd (<20 kg) 500 mg oral bd (≥20 kg) – 10 days oral treatment OR
- Benzathine benzylpenicillin 450mg (600 000 units) IM (<20 kg), 900 mg (1.2 million units) IM (>20 kg) as a single dose – 10 days oral treatment
- High-risk groups:
Quinsy (peritonsillar abscess) – Amoxicillin/Clavulanate 25 mg/kg (1 g) (Amoxicillin component) IV 8H (≥3 months and ≥4 kg) 10 days
Bites (animal/human) )Viridans streptococci, S. aureus, Group A streptococci, Oral anaerobes,E. corrodens, Pasteurella spp. (cat and dog), C. canimorsus (dog)_
- Amoxicillin/Clavulanate (400/57 mg/5 mL) 22.5 mg/kg (875 mg) (Amoxicillin component) 0.3 mL/kg (11 mL) oral bd 5 days
- Prophylaxis generally not required, except:
- Presentation delayed >8 hours
- Puncture wound unable to be adequately debrided
- Bite on hands, feet, face
- Bite involves deep tissues (e.g. bones, joints, tendons)
- Bite involves an open fracture
- Immunocompromised patient
- Cat bites
- Check tetanus immunisation status
If severe, penetrating injuries, esp. involving joints or tendons
Cellulitis – Mild/moderate (outpatient)
Flucloxacillin 25 mg/kg/dose orally QID (maximum 1 g/dose) (For children who can swallow capsules). OR
Clindamycin 7.5 mg/kg/dose orally QID (maximum 450 mg/dose) (Previous nmMRSA, History of boils or Aboriginal or Pacific islander descent) OR
Cefalexin 33 mg/kg (500 mg) oral tds (1 g max for moderate cellulitis) 5–10 days
Cellulitis – Moderate/severe (inpatient) – Flucloxacillin3 50 mg/kg (2 g) IV 6H or Ceftriaxone 50 mg/kg (2 g) IV daily (for hospital-in-the-home)
Dental abscess – Often polymicrobial – Amoxicillin 25 mg/kg (500 mg) oral tds -7 days and Dental/surgical management required
Head lice- 1% permethrin liquid or cream rinse, Repeat after one week
Impetigo – Group A streptococci S. aureus : Mupirocin 2% ointment top 8H if localised or Cefalexin 33 mg/kg (500 mg) oral bd 5 days
Lymphadenitis (cervical) – Mild Cefalexin 33 mg/kg (500 mg) oral tds 7 days
Scabies – Sarcoptes scabiei – Permethrin 5% cream top, One application from neck down; leave on for minimum of 8H (usually overnight), May need to repeat after 7 days
Treat whole family
Tonsillitis – Phenoxymethylpenicillin – 15 mg/kg/dose BD (maximum 500 mg/dose) for 10 days
Tonsillitis – Delayed type hypersensitivity – Azithromycin 10mg/kg orally once daily for 5 days.
Giardiasis – Metronidazole 30 mg/kg/dose orally once daily (maximum 2 g/dose) for 3 days.
Pinworms – Mebendazole- If less than or equal to 1 year old: 50 mg orally as a single dose.
If more than 1 year old: 100 mg orally as a single dose