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ANTIBIOTICS IN CHILDREN: Doses and Indications
NB: Recommendations are made on the assumption that, where appropriate, a no antibiotic or delayed antibiotic
strategy has been considered. A Patient Leaflet for this strategy can be accessed from
http://www.rcgp.org.uk/clinical‐and‐research/resources/toolkits/target‐antibiotic‐toolkit.aspx
RED denotes antibiotics with limited indications and are at a higher risk of causing Clostridium diarrhoea
These are the standard doses for indications commonly seen in primary care; for any other indication or if an
alternative needed due to allergy please see BNF for Children or contact microbiology for advice
ANTIBIOTIC MAIN INDICATIONS * DOSE *
Amoxicillin Acute otitis media – First line 1month ‐ 11 months 125mg TDS
Acute rhinosinusitis 1‐4 years 250mg TDS
Acute cough/acute bronchitis – First line 5‐17 years 500mg TDS
Lower UTI (if susceptible)
Cefalexin Uncomplicated UTI (3 days) – first line 1month ‐ 11 months 125mg BD
1‐4 years 125mg TDS
5‐11 years 250mg TDS
12‐17 years 500mg 2‐3 times a day
Clarithromycin Acute sore throat – second line Under 8kg 7.5mg per kg BD
If allergic to penicillin can be used for 8‐11kg 62.5mg BD
impetigo, acute sinusitis, infected eczema, 12‐19kg 125mg BD
cellulitis (if afebrile and healthy) and human 20‐29kg 187.5mg BD
bites (with metronidazole). 30‐40kg 250mg BD
12‐18 years 250mg BD
Co‐amoxiclav Acute Rhinosinusitis (persistent symptoms 1month ‐ 11 months 0.25ml per kg of
only) 125/31 TDS
Pyelonephritis (10days) – first line 1‐5 years 5ml of 125/31 TDS
Bites (human and animal) – first line 6‐11 years 5ml of 250/62 TDS
Facial cellulitis 12‐17 years 375mg tablet TDS
Abdominal infections
Ciprofloxacin Not recommended in children under 18 See BNF for children
Doxycycline Not recommended in children under 12 12‐17 years 200mg stat then 100mg daily
years – see BNF for Children
Erythromycin Respiratory tract infections (5 days) – 1month ‐ 1year 125mg QDS
second line (for other indications see BNF 2‐7 years 250mg QDS
for Children) 8‐17 years 50‐500mg QDS
Flucloxacillin Impetigo 1month ‐ 1 year 62.5mg–125mg QDS
Infected eczema 2‐9 years 125‐250mg QDS
Cellulitis if afebrile and healthy 10‐17 years 250‐500mg QDS
Nitrofurantoin Uncomplicated UTIs – first line Do not use if under 3 months of age
Avoid if eGFR less than 45ml/min/1.73m2 Immediate release preparations
3 months ‐ 11years 750micrograms per kg
QDS for 3 days
12‐17 years 50mg QDS for 3 days
(Modified release preparation
12‐17 years 100mg BD)
Phenoxymethylpenicillin Tonsillitis/acute sore throat – first line 1month ‐ 11 months 62.5mg QDS
Acute sinusitis – first line 1‐5 years 125mg QDS
6‐11 years 250mg QDS
12‐17 years 500mg QDS
Trimethoprim Uncomplicated UTIs (3 days) – second line 6 weeks ‐ 5months 25mg BD for 3 days
6month ‐ 5years 50mg BD for 3days
6 years ‐ 11years 100mg BD for 3days
Over 12 years 200mg BD for 3 days
References
BNF for Children, 2017‐2018 Edition
Aneurin Bevan University Health Board Antimicrobial Guidelines (accessed July 20th 2018)
Status: Approved Issue Date: Nov. 2015 (Reviewed July 2018)
Approved by: ABUHB AWG Page 1 of 1 Review date: July 2019