TABLE 1.
Standard treatment guidelines for LRTI, Gondama Hospital, Sierra Leone
| Age | Type of anti-infective | Dosage | Treatment frequency | Treatment duration |
| A Severe LRTI | ||||
| First-line | ||||
| 1–2 months | Ceftriaxone IM/IV | 50 mg/kg/day | Once daily | Minimum 3 days |
| Followed by amoxicillin PO | 100 mg/kg/day | 3×/day | Complete 7–10 days | |
| 2 months–5 years | Ampicillin IM/IV | 100 mg/kg/day | 3 or 4×/day | Until no more serious illness |
| Followed by amoxicillin PO | 100 mg/kg/day | 3×/day | Complete 7–10 days | |
| + Gentamicin IM | 3–6 mg/kg/day | Once daily | 7 days | |
| Chloramphenicol IM/IV | 100 mg/kg/day | 3×/day | Minimum 5 days | |
| Followed by chloramphenicol PO | 100 mg/kg/day | 3×/day | Complete 7–10 days | |
| >5 years | Benzylpenicillin procaine + benzylpenicillin IM | 100 000 IU/kg/day | Once daily | 2–3 days |
| Followed by amoxicillin PO | 100 mg/kg/day | 3×/day | Complete 7–10 days | |
| Ampicillin IM/IV | 100 mg/kg/day | 3×/day | Until no more serious illness | |
| Followed by amoxicillin PO | 100 mg/kg/day | 3×/day | Complete 7 days | |
| Second-line | ||||
| 1–2 months | Ampicillin IM/IV | 100 mg/kg/day | 3 or 4×/day | Until no more serious illness |
| Followed by amoxicillin PO | 100 mg/kg/day | 3×/day | Complete 7–10 days | |
| + Gentamicin IM | 3–6 mg/kg/day | Once daily | 7 days | |
| 2 months–5 years | Ceftriaxone IM/IV | 50 mg/kg/day | Once daily | Minimum 3 days |
| Followed by amoxicillin PO | 100 mg/kg/day | 3×/day | Complete 7–10 days | |
| >5 years | Chloramphenicol IM/IV | 100 mg/kg/day | 3×/day | 2-3 days |
| Followed by chloramphenicol PO | 100 mg/kg/day | 3×/day | Complete 7 days | |
| Ceftriaxone IM/IV | 50 mg/kg/day | Once daily | Minimum 3 days | |
| Followed by amoxicillin PO | 100 mg/kg/day | 3×/day | Complete 7–10 days | |
| Persistent pneumonia | ||||
| First-line | Erythromycin PO | 50 mg/kg/day | 2 or 3×/day | 10 days |
| Second-line (>8 years only) | Doxycycline PO | 4 mg/kg/day | 2×/day | 10 days |
| Staphylococcus pneumonia | ||||
| First-line | Cloxacilline IV | 200 mg/kg/day | 3×/day | Until improvement |
| + Gentamicin IM/IV | 7.5 mg | Once daily | ||
| Followed by cloxacillin PO | Complete 10–14 days of treatment | |||
| Alternative (>2 months only) | Chloramphenicol IV | 100 mg/kg/day | 3×/day | Until improvement |
| Chloramphenicol PO | 100 mg/kg/day | 3×/day | Complete 10–14 days of treatment | |
| B Non-severe LRTI | ||||
| 1–2 months | Ceftriaxone IM/IV | 50 mg/kg/day | Once daily | Minimum 3 days |
| Followed by amoxicillin PO | 100 mg/kg/day | 3×/day | Complete 7–10 days | |
| 2 months–5 years | Amoxicillin PO | 100 mg/kg/day | 3×/day | 5 days |
| >5 years | Benzylpenicillin procaine + benzylpenicillin IM | 100 000 IU/kg/day | Once daily | 5 days |
| Amoxicillin PO | 100 mg/kg/day | 3×/day | 5 days | |
| Second-line | ||||
| 1–2 months | Ampicillin IM/IV | 100 mg/kg/day | 3 or 4×/day | Until no more serious illness |
| Followed by amoxicillin PO | 100 mg/kg/day | 3×/day | Complete 7–10 days | |
| + Gentamicin IM | 3–6 mg/kg/day | Once daily | 7 days | |
| 2 months–5 years | Chloramphenicol PO | 100 mg/kg/day | 3×/day | 5 days |
LRTI = lower respiratory tract infection; IM = intramuscular; IV = intravenous; PO = oral; IU = international unit.