| Antibiotic |
Dose |
Notes |
| Azithromycin |
10 mg/kg od, max 500 mg |
For prophylaxis use 3x per week dosing at:
less than 15kg: 10mg/kg od
15-40 kg: 250mg od
more than 40kg: 500mg od.
Comes as 250mg capsules, 250mg and 500mg tablets, or suspension 200mg/5ml |
| Cefalexin (cephalexin) |
1 month - 1yr: 125mg bd
1yr - 5yrs 125mg tds
5yrs - 12yrs 250mg tds
over 12yrs 500mg tds (increased to 1gm tds for severe infection) |
Comes as 125mg in 5ml suspension or 250mg and 500mg tablets/capsules |
| Ciprofloxacin |
less than 1 month: 15 mg/kg bd
older than 1 month: 20 mg/kg bd (max 750mg bd) |
First line oral anti-pseudomonal agent. Photosensitising. Joint pains occasionally. Milk will reduce absorption. Avoid milk for at least 30 mins before and after taking ciprofloxacin.
Comes as 100mg and 250mg and 500mg and 750mg tablets or suspension 250mg in 5ml |
| Clarithromycin |
BNF doses:
under 8 kg: 7.5mg/kg bd
8 11kg: 62.5 mg bd
12 19kg: 125 mg bd
20 29kg: 187.5 mg bd
30 40kg: 250 mg bd
(if more than 12 years old can increase to 500mg bd if necessary) |
Can cause tooth and tongue discolouration. Care needed as interacts with some drugs e.g. itraconazole, rifabutin check BNFc.
|
| Co-amoxiclav 400/57(Augmentin- Duo) |
2 months 2 yrs: 0.3 ml/kg bd;
2-6 yrs: 5 ml bd
7-12 yrs: 10 ml bd |
Care with CF liver disease. Co-amoxiclav 625mg tabs are to be used in preference to 2 x 375mg tabs to reduce clavulanic acid intake. |
| Co-amoxiclav 250/62 in 5ml |
1 month - 1 yr: 0.25ml/kg tds
1 yr - 6 yrs: 5ml tds
6-12 yrs: 10ml tds |
| Co-amoxiclav 500/125 tablets |
more than 6 yrs:(625mg tabs) 1 tab TDS |
| Co-trimoxazole |
6 weeks5 months: 120 mg bd
6 months5 years: 240 mg bd
611 years: 480 mg bd
1218 years: 960 mg bd |
Maintain adequate fluid intake. Treatment should be stopped if blood disorders or rashes develop. Advise patient/carer to report all rashes, sore throats and fevers. Avoid in severe liver disease. Can be useful for Stenotrophomonas.
Comes as 480mg and 960mg tablets or suspension 240mg/5ml or 480mg/5ml. |
| Doxycycline |
more than 12 years: 200 mg once daily on day 1 then 100 mg once daily thereafter (can increase to 200 mg daily if required). |
Patient MUST be more than 12 years (due to discoloration of growing teeth and bone). Take standing or sitting upright with 200 ml water (to avoid oesophageal irritation). Photosensitising.
Comes as 100mg tablets (there is a dispersible form - vibramycin-D). |
| Ethambutol |
15mg/kg od (max 1.5g od) |
Treatment of NTM. Monitor visual acuity.
Comes as 100mg and 400mg tablets. |
| Flucloxacillin |
30-35 mg/kg TDS
MAX 4 gms/day |
Give 1 hour BEFORE meals or on an empty stomach. Liquid tastes awful some brands may be tolerated better than others. Treatment dose now three times a day.
For prophylaxis use:
Weight 3-5kg: 125mg bd
Weight 5-9kg: 175mg bd
Weight 9-15kg: 250mg bd
Older children: 25 mg/kg bd (usual max 1 gm bd; rarely increased to 2gm bd).
Comes as 250mg and 500mg capsules or solution 125mg/5ml or 250mg/5ml. |
| Fusidic acid |
Fusidic acid suspension:
less than 1 yr: 15mg/kg tds
1-5 yrs: 250 mg tds (5 ml)
6-12 yrs: 500 mg tds (10 mls)
more than 12 yrs: 750 mg tds (15mls) or 750mg sodium fusidate tablets tds |
Caution in CF liver disease. Take with or after food. Should always be prescribed with additional anti-staphylococcal agent.
Comes as fusidic acid suspension 250mg/5ml or sodium fusidate tablets 250mg. Sodium fusidate tablets are preferred in the over 12s as absorption is better than fusidic acid. |
| Linezolid |
less than 12 yrs: 10mg/kg (max 600mg) tds.
more than 12 yrs:600 mg bd |
Last line for MRSA or S aureus where patients have not responded to conventional agents e.g. high dose flucloxacillin, rifampicin, fusidic acid. Courses more than 28 days leads to risk of optic neuropathy so patients having 4 week or repeated courses should have ophthalmic exam before starting first course and every 2 months after. Aim for 2 week courses. Where possible patients should be warned to immediately report any visual changes, regardless of treatment duration. Monitor FBC weekly.
Comes as 600mg tablets or suspension 100mg/5ml. |
| Minocycline |
more than 12 yrs: 100mg bd |
Can be useful for Stenotrophomonas maltophilia.
Patient MUST be more than 12 years (due to discoloration of growing teeth and bone). Caution in CF liver disease. Take standing or sitting upright with plenty of water (see doxycycline).
Comes as 100mg tablets or capsules. |
| Rifampicin |
10 mg/kg (max 600mg) bd for staph (usually 2 week course)
10 mg/kg (max 600mg) od when used as part of long term treatment of NTM |
Second line for S aureus. Usually give with fusidic acid. Give 30 60 minutes before food. Caution in CF liver disease. Please note rifampicin interacts with many drugs (including itraconazole, voriconazole, chloramphenicol) so always check in BNFc. Check re oral contraceptive interactions. Can cause red staining of urine, tears and saliva.
Comes as 150mg and 300mg capsules or syrup 100mg/5ml. |
