Table 1.

Choices of antibiotic recommendations for various diagnoses

		Dosage
Sepsis in a child aged <2 months
Ampicillin intravenous		50 mg/kg QID for 7–10 days (21 days for meningitis)
	plus gentamicin intravenous	5–7·5 mg/kg daily for 7–10 days (21 days for meningitis)
Second line: ceftriaxone intravenous		50–100 mg/kg once daily for 7–10 days
Sepsis in a child aged <2 months where referral is not possible
Amoxicillin oral		50 mg/kg BID for 7 days
	plus gentamicin intramuscular or intravenous	5–7·5 mg/kg daily for 2–7 days
Sepsis in a child aged <2 months if skin conditions suggest Staphylococcus aureus
Cloxacillin or flucloxacillin intravenous		25–50 mg/kg BID or QID (age dependent) for 7–10 days
	plus gentamicin	5–7·5 mg/kg daily for 7–10 days (21 days for meningitis)
Sepsis in a child aged >2 months
Ampicillin intravenous		50 mg/kg QID for 7–10 days
	plus gentamicin intravenous or intramuscular	7·5 mg/kg daily for 7–10 days
Second line: ceftriaxone intravenous or intramuscular		50 mg/kg BID or 100 mg/kg daily for 7–10 days
Sepsis in a child aged >2 months if skin conditions suggest S aureus
Flucloxacillin intravenous		50 mg/kg QID for 7–10 days
	plus gentamicin	7·5 mg/kg daily
Typhoid fever
Ciprofloxacin oral		15 mg/kg BID for 7–10 days
Second line: intravenous ceftriaxone		80–100 mg/kg daily for 5–7 days
	or azithromycin oral	20 mg/kg daily for 5–7 days
Pneumonia
Ampicillin intravenous		50 mg/kg QID for 7–10 days
	plus gentamicin intravenous	7·5 mg/kg daily for 7–10 days
Second line: ceftriaxone intravenous		80 mg/kg daily for 7–10 days
Pneumonia (if S aureus is suspected)
Flucloxacillin or cloxacillin intravenous		50 mg/kg QID for 7–10 days
	plus gentamicin	7·5 mg/kg intramuscular or intravenous once a day
Dysentery (presumed due to Shigella spp)
Ciprofloxacin oral		15 mg/kg BID for 3 days
Second line: ceftriaxone intravenous		50–80 mg/kg daily for 3 days
Osteomyelitis
Chloramphenicol		25 mg/kg TID
Second line: cloxacillin or flucloxacillin intravenous		50 mg/kg QID for up to 5 weeks (step down to oral once clinically improving)
	or clindamycin or third-generation cephalosporins	No dosages specified; clear circumstances of when such therapy would be appropriate are not outlined
Meningitis in neonates
Ampicillin		50 mg/kg BID for 3 weeks
	plus gentamicin	5–7·5 mg/kg daily for 3 weeks
Ceftriaxone intravenous		50–75 mg/kg daily for 3 weeks
	plus gentamicin	5–7·5 mg/kg daily for 3 weeks
Cefotaxime		50 mg/kg BID or TID (age dependent) for 3 weeks
	plus gentamicin	5–7·5 mg/kg daily for 3 weeks
Meningitis in children older than 28 days
Ceftriaxone intravenous		50 mg/kg intramuscular or intravenous BID for 7–10 days
Second line: cefotaxime intravenous		50 mg/kg intramuscular or intravenous QID for 7–10 days
Meningitis in children older than 28 days with no known resistance to chloramphenicol or β-lactams locally
Chloramphenicol intravenous		25 mg/kg QID for 10 days
	plus ampicillin intramuscular or intravenous	50 mg/kg QID for 10 days
	or benzylpenicillin intravenous	60 mg/kg QID for 10 days
Urinary tract infection
Co-trimoxazole oral		4 mg/kg plus 20 mg/kg BID for 5 days
Second line: ampicillin		50 mg/kg intramuscular or intravenous every 6 h
	plus gentamicin	5–7·5 mg/kg daily

First-line and second-line treatment guidelines for common paediatric infective illnesses. Data are from WHO pocket book of hospital care for children²¹ and WHO guideline for managing possible serious bacterial infection in young infants when referral is not feasible.²² BID=twice daily. TID=three times daily. QID=four times daily.