October 6, 2001
When antibiotics are appropriate for kids, which ones are best?
BY DENNIS CONNAUGHTON
Kids are always getting ear and throat infections, and treatment with antibiotics is sometimes the right choice. However, choosing the right antibiotic and the proper dosage for the child's problem is not always an easy decision.
In a Dialogue session yesterday, Thomas Irons, M.D., professor of pediatrics at the Brody School of Medicine at East Carolina University, Greenville, N.C., had this advice on antibiotic use in children:
- In children under 3 with otitis media, amoxicillin at a dose of 80 to 90 mg/kg/day is the treatment of choice when antibiotic treatment is appropriate. If the treatment fails after three days, try amoxicillin-clavulanate, cefuroxime axetil or ceftriaxone.
- For children with external otitis, use quinolones, such as combinations of ciprofloxacin, gentamicin or tobramycin and generic polymyxin or ciprofloxacin combined with hydrocortisone.
- For the treatment of acute bacterial sinusitis in children under 2 with mild to moderate disease, amoxicillin at 45 mg/kg/day is the treatment of choice. If the child does not respond, amoxicillin-clavulanate is an appropriate choice.
- If a child has an invasive infection of strep A, or fasciitis, clindamycin may be more effective than penicillin because it suppresses toxin and protein synthesis.
FP Report is published by the AAFP News Department.
Copyright © 2001 by American Academy of Family Physicians.
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