Table 6.
Antibiotic doses for pediatric patients.
| Drug | Intravenous dosing | Maximum daily dosage | Comments |
|---|---|---|---|
| Amikacin | Neonates: 0–4 weeks of age and<1200 g, 7.5 mg/kg every 18–24 h; postnatal age ≤7 days and 1200–2000 g, 7.5 mg/kg every 12 h; postnatal age ≤7 days and >2000 g, 7.5–10 mg/kg every 12 h; postnatal age >7 days and 1200–2000 g, 7.5–10 mg/kg every 8–12 h; postnatal age >7 days and >2000 g, 10 mg/kg every 8 h Infants and children: 15–22.5 mg/kg/day divided every 8 h |
… | Some consultants recommend initial doses of 30 mg/kg/day divided every 8 h in patients whose serum levels document the need (i.e., cystic fibrosis or febrile neutropenic patients). |
| Ampicillin | Neonates: postnatal age ≤7 days and ≤2000 g: 50 mg/kg/day divided every 12 h; postnatal age ≤7 days and >2000 g, 75 mg/kg/day divided every 8 h; postnatal age >7 days and <1200 g, 50 mg/kg/day divided every 12 h; postnatal age >7 days and 1200–2000 g, 75 mg/kg/day divided every 8 h; postnatal age >7 days and >2000 g, 100 mg/kg/day divided every 6 h Infants and children: 100–200 mg/kg/day divided every 6 h |
12 g | … |
| Ampicillin-sulbactam | Infants: 100–150 mg ampicillin/kg/day divided every 6 h Children: 100–200 mg ampicillin/kg/day divided every 6 h |
8 g of ampicillin | … |
| Anidulafungin | Children 2– 17 years of agea: 1.5 mg/kg/day | 100 mg | Experience in children is limited. |
| Caspofungin | Children 2–11 years of age: loading dose of 70 mg/m2/day on day 1 followed by 50 mg/m2/day thereafter Children ≥12 years of age: loading dose: 70 mg on day 1, followed by 50 mg once daily thereafter |
70 mg (loading) 50 mg (maintenance) | … |
| Cefazolin | Children >1 month of age: 75 mg/kg q8h | … | … |
| Cefepime | Neonates ≤14 days of age: 30 mg/kg every 12 h Infants > 14 days of ageb and Children ≤40 kg in weight: 50 mg/kg every 12 h |
… | No recommendation available for infants 2 weeks to 2 months of age. |
| Ceftazidime | Neonates: 0–4 weeks of age and <1200 g, 100 mg/kg/day divided every 12 h; postnatal age ≤7 days and 1200–2000 g, 100 mg/kg/day divided every 12 h; postnatal age ≤7 days and >2000 g: 100–150 mg/kg/day divided every 8–12 h; postnatal age >7 days and ≥1200 g, 150 mg/kg/day divided every 8 h Infants and children ≤12 years of age: 100–150 mg/kg/day divided every 8 h |
6 g | |
| Cefotaxime | Children >1 month of age | 150 mg/kg every 8 h | … |
| Ceftriaxone | Neonates: postnatal age ≤7 days, 50 mg/kg/day given every 24 h; postnatal age >7 days and ≤2000 g, 50 mg/kg/day given every 24 h; postnatal age >7 days and >2000 g, 50–75 mg/kg/day given every 24 h Infants and children: 50–75 mg/kg/day divided every 12–24 h |
… | Should not be used in hyperbilirubinemic neonates. |
| Ciprofloxacin | Neonates: 7–40 mg/kg/day divided every 12 h Infants and children: 20–30 mg/kg/day divided every 12 h |
800 mg | Experience in neonates is limited. The risks and benefits of fluoroquinolones in children should be assessed prior to use. |
| Fluconazole | Neonates, infants, and children: 12 mg/kg/day once daily | … | … |
| Gentamicin | Neonates: premature neonates and <1000 g, 3.5 mg/kg every 24 h; 0–4 weeks and <1200 g, 2.5 mg/kg every 18–24 h; postnatal age ≤7 days: 2.5 mg/kg every 12 h; postnatal age >7 days and 1200–2000 g, 2.5 mg/kg every 8–12 h; postnatal age >7 days and >2000 g, 2.5 mg/kg every 8 h; once daily dosing for premature neonates with normal renal function, 3.5–4 mg/kg every 24 h; once daily dosing for term neonates with normal renal function, 3.5–5 mg/kg every 24 h Infants and children <5 years of age: 2.5 mg/kg every 8 h; once daily dosing in patients with normal renal function, 5–7.5 mg/kg every 24 h Children ≥5 years of age: 2–2.5 mg/kg every 8 h; once daily dosing in patients with normal renal function, 5–7.5 mg/kg every 24 h |
… | Some patients may require larger or more frequent doses (e.g., every 6 h) if serum levels document the need (i.e., cystic fibrosis, patients with major burns, or febrile neutropenic patients). |
| Imipenem-cilastatin | Neonates: 0–4 weeks of age and <1200 g, 20 mg/kg every 18–24 h; postnatal age ≤7 days, and 1200–1500 g, 40 mg/kg/day divided every 12 h; postnatal age ≤7 days and >1500 g, 50 mg/kg/day divided every 12 h; postnatal age >7 days and 1200–1500 g, 40 mg/kg/day divided every 12 h; postnatal age >7 days and >1500 g, 75 mg/kg/day divided every 8 h Infants <3 months of age: 100 mg/kg/day divided every 6 h Infants ≥3 months of age and children: 60–100 mg/kg/day divided every 6 h |
4 g | … |
| Levofloxacin | Children 6 months to 5 years of age: 10 mg/kg every 12 h Children ≥5 years of age: 10 mg/kg every 24 h with a maximum dose of 500 mg |
500 mg | Experience in children is limited. The risks and benefits of fluoroquinolones in children should be assessed prior to use. |
| Linezolid | Neonates: 0–4 weeks of age and birthweight <1200 g: 10 mg/kg every 8–12 h (note: use every 12 h in patients <34 weeks gestation and <1 week of age); <7 days of age and birthweight ≥1200 g, 10 mg/kg every 8–12 h (note: use every 12 h in patients < 34 weeks gestation and < 1 week of age); ≥7 days and birthweight ≥1200 g, 10 mg/kg every 8 h Infants and children <12 years of age: 10 mg/kg every 8 h Children ≥12 years of age and adolescents: 10 mg/kg every 12 h |
600 mg | … |
| Meropenem | Neonates: postnatal age 0–7 days, 20 mg/kg every 12 h; postnatal age >7 days and 1200–2000 g, 20 mg/kg every 12 h; postnatal age >7 days and >2000 g, 20 mg/kg every 8 h Infants ≥3 months of age and children: 20 mg/kg every 8 h |
1 g | … |
| Micafungin | Children >2 years of age: 3 mg/kg/day | 150 mg | Younger children, infants, and neonates are likely to require higher doses, but no recommendation is currently available. |
| Nafcillin | Neonates: 0–4 weeks of age and <1200 g, 50 mg/kg/day in divided doses every 12 h; ≤7 days and 1200–2000 g, 50 mg/kg/day in divided doses every 12 h; ≤7 days of age and >2000 g, 75 mg/kg/day in divided doses every 8 h; >7 days of age and 1200–2000 g, 75 mg/kg/day in divided doses every 8 h; >7 days of age and >2000 g, 100 mg/kg/day in divided doses every 6 h Infants and children: 100–200 mg/kg/day in divided doses every 4–6 h |
12 g | … |
| Oxacillin | Neonates: 0–4 weeks of age and <1200 g, 50 mg/kg/day in divided doses every 12 h; postnatal age <7 days and 1200–2000 g: 50–100 mg/kg/day in divided doses every 12 h; postnatal age <7 days and 1200–2000 g, 75–150 mg/kg/day in divided doses every 8 h; postnatal age ≥7 days and 1200–2000 g: 75–150 mg/kg/day in divided doses every 8 h; postnatal age ≥7 days and >2000 g, 75–150 mg/kg/day in divided doses every 8 h Infants and children: 150–200 mg/kg/day in divided doses every 4–6 h |
12 g | … |
| Quinupristin-dalfopristin | Infants and children: 7.5 mg/kg every 8 h | … | Experience in children is limited. Recommended dosage based on 0.1 to 18 years of age. |
| Ticarcillin | Neonates: postnatal age ≤7 days and ≤2000 g, 150 mg/kg/day in divided doses every 12 h; postnatal age ≤7 days and >2000 g, 225 mg/kg/day in divided doses every 8 h; postnatal age >7 days and <1200 g, 150 mg/kg/day in divided doses every 12 h; postnatal age >7 days and 1200–2000 g, 225 mg/kg/day in divided doses every 8 h; postnatal age >7 days and >2000 g, 300 mg/kg/day in divided doses every 6–8 h Infants and children: 200–300 mg/kg/day in divided doses every 4–6 |
24 g | … |
| Tobramycin | Neonates: preterm neonates <1000 g, 3.5 mg/kg every 24 h; 0–4 weeks of age and <1200 g, 2.5 mg/kg every 18 h; postnatal age ≤7 days and 1200–2000 g, 2.5 mg/kg every 12 h; postnatal age ≤7 days and >2000 g, 2.5 mg/kg every 8 h Infants and children <5 years of age: 2.5 mg/kg every 8 h Children ≥5 years of age: 2–2.5 mg/kg every 8 h |
… | Some patients may require larger or more frequent doses (e.g., every 6 h) if serum levels document the need (i.e., cystic fibrosis, patients with major burns, or febrile neutropenic patients). |
| TMP-SMX | Infants >2 months of age and children: mild-to-moderate infections, 6–12 mg TMP/kg/day in divided doses every 12 h; serious infection, 15–20 mg TMP/kg/day in divided doses every 6–8 h | … | … |
| Vancomycin | Neonates: postnatal age ≤7 days and <1200 g, 15 mg/kg/day given every 24 h; postnatal age ≤7 days and 1200–2000 g, 10–15 mg/kg given every 12–18 h; postnatal age ≤7 days and >2000 g, 10–15 mg/kg given every 8–12 h; postnatal age >7 days and <1200 g, 15 mg/kg/day given every 24 h; postnatal age >7 days and 1200–2000 g, 10–15 mg/kg given every 8–12 h; postnatal age >7 days and >2000 g, 15–20 mg/kg given every 8 h Infants and children: 40 mg/kg/day in divided doses every 6–8 h |
… | … |
| Voriconazole | Children >2 years of age: 7 mg/kg every 12 h for 2 doses on day 1 (loading dose) followed by 4 mg/kg every 12 h (note: doses as high as 8 mg/kg every 12 h have been reported | … | … |