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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
