Treatment of infections

If the child appears to have no complications give:

Oral amoxicillin 15mg/kg 8-hourly for 5 days

If child has complications (eg; septic shock, hypoglycaemia, hypothermia, skin infections or dermatosis, respiratory or urinary tract infections, or lethargic/sickly appearance), select antibiotic as shown in the table below:

Status Antibiotics
All admitted cases with any complications other than shock, meningitis or dysentery
  • Inj. Ampicillin 50 mg/kg/dose 6 hrly and Inj. Gentamicin 7.5 mg/kg once a day for 7 days
  • Add Inj. Cloxacillin 100 mg/kg day 6 hrly if staphylococcal infection is suspected
  • Revise therapy based on sensitivity report
For septic shock or worsening/no improvement in initial hours
  • Give third generation cephalosporins like Inj. Cefotaxime 150 mg/kg/day in 3 divided doses or Ceftriaxone 100 mg/kg/day in 2 divided doses along with Inj Gentamicin 7.5 mg/kg in single dose.
  • Do not give second dose until child is passing urine.)
Meningitis IV Cefotaxime 50mg/kg/dose 6hrly or Inj Ceftriaxone 50 mg/kg 12 hrly plus Inj. Amikacin 15 mg/kg/day divided in 8 hrly doses.
Dysentery Give Ciprofloxacin 15mg/kg in two divided doses per day for 3 days. If child is sick or has already received ciprofloxacin, give Inj. Ceftriaxone 100 mg/kg once a day or divided in 2 doses for 5 days

Duration of antibiotic therapy depends on the diagnosis i.e.

Suspicion of clinical sepsis: at least 7 days

Urinary tract infection: 7–10 days

Culture positive sepsis: 10–14 days

Meningitis: at least 14–21 days

Deep seated infections like arthritis and osteomyelitis: at least 4 weeks.

If clinical condition does not improve after 5 days of antibiotics treatment, reassess the child (check for sites of infection and potentially resistant organisms) and take appropriate measures. If there is partial improvement after 5 days, complete a full 10-day course.