Page 226 - HPP ANTIMICROBIAL GUIDELINE 2018
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Suggested Treatment
                     Infection/Condition                                                                                              Comments
                                                              Preferred                             Alternative

                 Liver abscess (pyogenic)    Empiric:                                    Clindamycin 10 mg/kg  IV q8h       Surgical drainage is needed in
                 S. aureus, Gram negative,   Cloxacillin 50mg/kg IV q6h                                                     most cases
                 Anaerobes                                                               PLUS
                                             PLUS                                        Gentamicin
                                             Ceftriaxone 50mg/kg IV q12h                 ≤10 yr: 8mg/kg IV day1, then 6mg/kg
                                                                                         daily
                                             PLUS                                        >10 yr: 7mg/kg IV day1, then 5mg/kg
                                             Metronidazole 7.5mg/kg IV q8h               daily


                 Acute cholangitis           Ampicillin 25-50mg/kg  IV q6h               Cefoperazone 25-50mg/kg IV q6-8h
                 Gram negative, anaerobes,
                 gram positive               PLUS                                        PLUS
                                             Gentamicin   5mg/kg IV q24h                 Metronidazole 7.5mg/kg IV q8h

                                             PLUS
                                             Metronidazole 7.5mg/kg IV q8h for 7-14 days

                 Peritonitis
                 Spontaneous bacterial       Ceftriaxone 50mg/kg IV q12h                 Cefotaxime 50mg/kg IV q6h          Penicillin in case of nephrotic
                 peritonitis: mostly                                                                                        syndrome
                 Enterobacteriaceae

                 Secondary peritonitis:      Ceftriaxone 50mg/kg IV q12h                 Cefotaxime 50mg/kg IV q6h
                 polymicrobial
                                             Plus                                        Plus
                                             Metronidazole 7.5mg/kg IV q8h               Metronidazole 7.5mg/kg IV q8h


               References  :
               1.      Cunha BA. Antibiotic Essentials 2012. 11th Edition
               2.      The Sanford Guide to Antimicrobial Therapy 2011-2012
               3.      Liver Abscess in Children: A 10-year Single Centre Experience Saudi J Gastroenterology 2011; 17(3)199
               4.      Cherry J, Demmler-Harisson GJ, Kaplan SL, et al. Feigin & Cherry’s Textbook of Paediatric Infectious Diseases 6th Ed
               5.      Frank Shann, Sixteenth Edition 2014



               HPP AMG                                                    Gastrointestinal Infection                                                    108
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