Page 266 - HPP ANTIMICROBIAL GUIDELINE 2018
P. 266

Infection/Condition                                      Suggested Treatment                                          Comments
                                                             Preferred                                   Alternative

                 Leptospirosis
                 L. icterohaemorrhagiae    Benzylpenicillin 100,000 units/kg IV q6h       Ceftriaxone 80-100mg/kg IV q24h
                 Moderate to severe disease   (max 6-12 millions unit/day) for 7 days     (max 2gm/day) for 7 days

                                                                                          OR
                                                                                          Cefotaxime 150-200mg/kg/24h IV q6h-q8h
                                                                                          (max 12gm/day)  for 7 days


                 Mild disease              Amoxicillin 25-50mg/kg PO q6h-q8h              For children > 8 yr:
                                           (max 500mg/dose) for 7 days                    Doxycycline 2mg/kg PO q12h
                                                                                          (max 200mg/day) for 7 days


                 Tetanus                   Refer to Neonatal Infections Section


                 Melioidosis
                 Burkholderia pseudomallei

                 Intensive/Induction therapy:  Ceftazidime 200mg/kg/24h IV q6h for 10-14 days   For children > 8 yr: Imipenem/cilastatin    Parenteral treatment
                                                                                          75-100mg/kg/24h IV q6-8h                   should be used for at
                                                                                                                                     least 10-14 days or
                                                                                          OR                                         until clear improvement
                                                                                          Meropenem 75mg/kg/24h IV q8h               is noted

                                                                                                                                     Folic Acid 5mg PO
                 Maintenance therapy:      Amoxicillin (60mg/kg/24h)/ clavulanate PO q8h                                             q24h to be given for
                                                                                                                                     patient on trimethoprim/
                                           OR                                                                                        sulfamethoxazole
                                           Trimethoprim(TMP)/sulfamethoxazole TMP
                                           8mg/kg PO q12h                                                                            Duration: 12-20 weeks






               HPP AMG                                                       Tropical Infections                                                        128
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