Abstract
A combination of ampicillin and gentamicin as first line therapy for suspected non-meningitic septicaemia in children is apprropriate first-line therapy. Ampicilin should be given in high dose (200-300 mg/kg/day) to overcome penicillin-resistance among pneumococci. Once daily gentamicin has been proven to be safe, effective and associated with less toxicity than more frequent doses. Where meningitis is suspected, the options are chloramphenicol of a third-generation cephalosporin. A third-generation cephalosporin (e.g. ceftriaxone) will be preferable to chloramphenicol where resistance to chloramphenicol and penicillin among H. influenzae and S. pneumoniae is common. Anti-staphylococcal antibiotics (such as betalactamase stable penicillins flucloxacillin or cloxacillin) should be given as first-line treatment if there are suggestive skin lesions, abscesses, bone or joint infection, or if other signs of staphylococcal infection (such as pneumatocoeles or empyema) are present. If either flucloxacillin or cloxacillin are not available, chloramphenicol will have some anti-staphylococcal activity. Further studies are needed to follow antimicrobial susceptibility in developing counries so that empirical treatment recommendations maintain a strong evidence base. Restricting the use of third-generation cephalosporins and beta-lactamase stable penicillins to where there are specific indications will reduce the development of antibiotic resistance.
| Original language | English (US) |
|---|---|
| Pages (from-to) | 46-48 |
| Number of pages | 3 |
| Journal | Journal of Tropical Pediatrics |
| Volume | 52 |
| Issue number | 1 |
| DOIs | |
| State | Published - Feb 2006 |
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ASJC Scopus subject areas
- Pediatrics, Perinatology, and Child Health
- Public Health, Environmental and Occupational Health
- Immunology
Cite this
Evidence behind the WHO guidelines : Hospital care for children. / Ryan, Mary; McCracken, George H.
In: Journal of Tropical Pediatrics, Vol. 52, No. 1, 02.2006, p. 46-48.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Evidence behind the WHO guidelines
T2 - Hospital care for children
AU - Ryan, Mary
AU - McCracken, George H.
PY - 2006/2
Y1 - 2006/2
N2 - A combination of ampicillin and gentamicin as first line therapy for suspected non-meningitic septicaemia in children is apprropriate first-line therapy. Ampicilin should be given in high dose (200-300 mg/kg/day) to overcome penicillin-resistance among pneumococci. Once daily gentamicin has been proven to be safe, effective and associated with less toxicity than more frequent doses. Where meningitis is suspected, the options are chloramphenicol of a third-generation cephalosporin. A third-generation cephalosporin (e.g. ceftriaxone) will be preferable to chloramphenicol where resistance to chloramphenicol and penicillin among H. influenzae and S. pneumoniae is common. Anti-staphylococcal antibiotics (such as betalactamase stable penicillins flucloxacillin or cloxacillin) should be given as first-line treatment if there are suggestive skin lesions, abscesses, bone or joint infection, or if other signs of staphylococcal infection (such as pneumatocoeles or empyema) are present. If either flucloxacillin or cloxacillin are not available, chloramphenicol will have some anti-staphylococcal activity. Further studies are needed to follow antimicrobial susceptibility in developing counries so that empirical treatment recommendations maintain a strong evidence base. Restricting the use of third-generation cephalosporins and beta-lactamase stable penicillins to where there are specific indications will reduce the development of antibiotic resistance.
AB - A combination of ampicillin and gentamicin as first line therapy for suspected non-meningitic septicaemia in children is apprropriate first-line therapy. Ampicilin should be given in high dose (200-300 mg/kg/day) to overcome penicillin-resistance among pneumococci. Once daily gentamicin has been proven to be safe, effective and associated with less toxicity than more frequent doses. Where meningitis is suspected, the options are chloramphenicol of a third-generation cephalosporin. A third-generation cephalosporin (e.g. ceftriaxone) will be preferable to chloramphenicol where resistance to chloramphenicol and penicillin among H. influenzae and S. pneumoniae is common. Anti-staphylococcal antibiotics (such as betalactamase stable penicillins flucloxacillin or cloxacillin) should be given as first-line treatment if there are suggestive skin lesions, abscesses, bone or joint infection, or if other signs of staphylococcal infection (such as pneumatocoeles or empyema) are present. If either flucloxacillin or cloxacillin are not available, chloramphenicol will have some anti-staphylococcal activity. Further studies are needed to follow antimicrobial susceptibility in developing counries so that empirical treatment recommendations maintain a strong evidence base. Restricting the use of third-generation cephalosporins and beta-lactamase stable penicillins to where there are specific indications will reduce the development of antibiotic resistance.
UR - http://www.scopus.com/inward/record.url?scp=31744451877&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=31744451877&partnerID=8YFLogxK
U2 - 10.1093/tropej/fmk007
DO - 10.1093/tropej/fmk007
M3 - Article
C2 - 16436544
AN - SCOPUS:31744451877
VL - 52
SP - 46
EP - 48
JO - Journal of Tropical Pediatrics
JF - Journal of Tropical Pediatrics
SN - 0142-6338
IS - 1
ER -