Page 224 - HPP ANTIMICROBIAL GUIDELINE 2018

Suggested Treatment
Infection/Condition Comments
Preferred Alternative

Typhoid fever
Salmonella Typhi
S. paratyphi *Fluoroquinolones need to be
Mild or uncomplicated Ceftriaxone 50mg/kg q12h IV Ciprofloxacin 15mg/kg PO q12h for used with caution in children due
5-7 days to possible arthropathy and rapid
development of resistance.
Severe infection or suspected Ceftriaxone 50mg/kg IV q12h for 5-7days Ciprofloxacin IV 10-15mg/kg IV q12h However, there is now increasing
resistant organism for 7-14 days data on safety and efficacy of
quinolones in children
Chronic carrier state Ampicillin/amoxicillin 100mg/kg/24h PO in Trimethoprim(TMP)/sulfamethoxazole
(> 1 year) q6-8h for 6 weeks TMP 8 mg/kg/24h PO in q12h for
6 weeks

Cholera >8kg: Doxycycline 4.4mg/kg PO daily as Trimethoprim(TMP)/ Oral or IV rehydration is the
single dose sulfamethoxazole cornerstone of treatment.
TMP 8-10mg/kg/24h PO in q12h for
OR 3 days Antibiotics therapy reduces the
Azithromycin: 12 mg/kg PO daily at Day 1, volume and duration of diarrhoea
Day 2-3: 6 mg/kg PO daily Erythromycin 50mg/kg/24h PO in q6h
for 3 days Monitor antimicrobial sensitivity
(for strains resistant to tetracyclines) pattern at beginning of & during
the outbreak as it can change

Avoid using tetracycline or
Doxycycline for young children
as they can cause staining of the
teeth

Liver abscess (amoebic) Metronidazole 7.5mg/kg IV q8h Amoebic abscess tend to be
Entamoeba histolytica for 10-14 days solitary lesion.

Consider surgical drainage if
needed

HPP AMG Gastrointestinal Infection 107