Paediatric Antimicrobial dosing and administration recommendations by indication

All CHQ staff are individually responsible and accountable for ensuring safe and appropriate use of antimicrobials (Antimicrobial Stewardship) in accordance with CHQ Antimicrobial procedures, guidelines and restrictions.

At the point of checking, preparing and/or administration, staff can utilise the CHQ AMS website alongside standard paediatric references, such as the AMH Children’s Dosing Companion and the RCH Paediatric Injectable Guidelines  to ensure that the patient is prescribed antimicrobials appropriately.

Checklist:

*Note that paediatric dosing recommendation in the below table is based on age and infection/disease state (Dosing recommendations based on normal renal and liver function. Seek expert advice if renal or liver impairment is present).

Antimicrobial name and route of administrationPaediatric dosing recommendation*AMS Restriction
Aciclovir (IV)Neonatal dosingAmber
Aciclovir (IV)HSV Encephalitis – infants (over 2 months old) and childrenAmber
AlbendazoleSnail and Slug Ingestion - Prophylaxis against Angiostrongylus cantonensis infection (rat lung worm)Amber
Amikacin (IV)Cystic fibrosis – Non Tuberculous Mycobacterium infectionRed
Amikacin (inhaled/ nebulised)Cystic fibrosis – Non Tuberculous Mycobacterium infectionRed
Amoxicillin/ Clavulanic acid (IV)Medication use guidelineAmber
Amoxicillin/ Clavulanic acid (IV)Dog bite, animal bite, retropharyngeal abscessAmber
Amoxicillin/ Clavulanic acid (IV)Appendicitis COMPLICATED (e.g. perforation, appendiceal collection / abscess), Peritonitis, Necrotising enterocolitisAmber
Amoxicillin (oral)Periapical AbscessGreen
Amoxicillin (oral)Periodontal AbscessGreen
Amoxicillin (oral)PericoronitisGreen
Amoxicillin (oral)Alveolar OsteitisGreen
Amoxicillin (oral)Avulson (up to 8 years of age)Green
Amoxycillin (Amoxicillin) (IV)Neonatal dosingGreen
Amoxycillin (Amoxicillin) (IV)Appendicitis (UNCOMPLICATED, no perforation)Green
Amoxycillin (Amoxicillin) (PO)Acute otitis mediaGreen
Amoxycillin (Amoxicillin) (PO)Community acquired pneumonia (CAP) – oral antibiotics – Infants and children (more than 1 month old) (non PICU)Green
Amoxycillin (Amoxicillin) (PO)Non-typhoidal Salmonellosis in ChildrenGreen
Amoxycillin / Clavulanic acid (Amoxicillin / Clavulanic acid) (PO)Cystic fibrosis OutpatientGreen
Amoxycillin / Clavulanic acid (Amoxicillin / Clavulanic acid) (PO)Non CF bronchiectasis – OutpatientGreen
Amoxycillin / Clavulanic acid (Amoxicillin / Clavulanic acid) (PO)Appendicitis (Early IV to oral switch)Green
Amoxycillin / Clavulanic acid (Amoxicillin / Clavulanic acid) (PO)Animal bites or wounds inflicted by animal (non PICU) (Early IV to oral switch)Green
Amoxicillin/clavulanate (IV)Facial Cellulitis (of Dental Origin)Amber
Amoxicillin/clavulanate (oral)Facial Cellulitis (of Dental Origin)Green
Amphotericin B Liposomal (Ambisome) (IV)CHQ-GDL-01075 Antifungal Prophylaxis and Treatment in Paediatric Oncology Patients and other Immunocompromised ChildrenAmber
Ampicillin (IV)Neonatal dosingGreen
Ampicillin (IV)Urinary tract infection/ Pyelonephritis (infants and children)Green
Ampicillin (IV)Appendicitis (UNCOMPLICATED, no perforation)Green
Anidulafungin (IV)CHQ-GDL-01075 Antifungal Prophylaxis and Treatment in Paediatric Oncology Patients and other Immunocompromised ChildrenRed
Artemether/ Lumefantrine (Riamet) (PO)Plasmodium falciparum MalariaRed
Artesunate (SAS) (IV)Severe/complicated Plasmodium falciparum MalariaRed
Atovaquone/ Proguanil (Malarone ) (PO)Plasmodium falciparum MalariaRed
Azithromycin (IV)Severe pneumonia (PICU)Amber
Azithromycin (IV)Pertussis (PICU)Amber
Azithromycin (PO)Pertussis (non PICU)Amber
Azithromycin (PO)Cystic fibrosis – anti-inflammatory (chronic lung disease)Amber
Azithromycin (PO)Non-typhoidal Salmonellosis in ChildrenAmber
Azithromycin (PO)Cystic fibrosis – non tuberculous mycobacterium infection (NTM)Amber
Aztreonam lysine (SAS) (inhaled/nebulised)Cystic fibrosis – OutpatientRed
Aztreonam (IV)Cystic fibrosis – pulmonary optimizationRed
Aztreonam (IV)Liver transplant – prophylaxis for patients with penicillin/cephalosporin anaphylaxisRed
Aztreonam (IV)Renal transplant – prophylaxis for patients with penicillin/cephalosporin anaphylaxisRed
Benzylpenicillin (IV)Neonatal dosingGreen
Benzylpenicillin (IV)Amputations – prophylaxisGreen
Benzylpenicillin (IV)EndocarditisGreen
Benzylpenicillin (IV)Community acquired pneumonia (CAP) – intravenous antibiotics – Infants and children (more than 1 month old) or Empyema (non PICU)Green
Caspofungin (IV)CHQ-GDL-01075 Antifungal Prophylaxis and Treatment in Paediatric Oncology Patients and other Immunocompromised Children Red
Cefalexin (PO)Cystic fibrosis – OutpatientGreen
Cefalexin (PO)Mild cellulitis, peri-orbital cellulitis, impetigo, cervical lymphadenitisGreen
Cefazolin 5 % eye dropsAcute management of Open Globe Injuries (penetrating eye injury/ ophthalmic/ eye infections/ keratitis)Amber
Cefazolin (IV)Cystic fibrosis – Pulmonary optimizationGreen
Cefazolin (IV)General Surgical antibiotic prophylaxis (refer to guideline for specific surgery recommendations)Green
Cefazolin (IV)Bone and joint infections (Osteomyelitis and septic arthritis)Green
Cefazolin (IV)Compound fractures - Open fractures – NO severe tissue damage/ NO evidence of infectionGreen
Cefazolin (IV)Cardiac Surgical antibiotic prophylaxisGreen
Cefazolin (IV) (ED HITH)Hospital-In-The-Home (HITH) Emergency/ ED pathways for Cellulitis, Community acquired pneumonia, Lymphadenitis, Peri-orbital cellulitisAmber
Cefepime (IV)Cystic fibrosis – Pulmonary optimizationAmber
Cefotaxime (IV)Neonatal dosingAmber
Cefotaxime (IV)Community acquired Sepsis (infants and children)Amber
Cefotaxime (IV)Meningitis (infants and children)Amber
Cefotaxime (IV)CSF shunt infection (infants and children)Amber
Cefotaxime (IV)Severe/ life threatening pneumonia (PICU) (infants and children)Amber
Cefotaxime (IV)Non CF bronchiectasis – Pulmonary optimizationAmber
Cefotaxime (IV)Non CF bronchiectasis – Pulmonary optimizationAmber
Cefotaxime (IV)Salmonella bacteraemia, meningitis or osteomyelitisAmber
Cefotaxime (IV)Tracheitis and epiglottitisAmber
Cefotaxime (IV)MastoiditisAmber
Cefotaxime (IV)CholangitisAmber
Cefotaxime (IV)Infants and children less than 5 years old and not HIB immune with Osteomyelitis, Septic arthritis, moderate to severe peri-orbital cellulitis, severe cellulitisAmber
Cefotaxime (IV)Suspected necrotising fasciitis (non PICU)Amber
Cefoxitin (IV)Abdominal, Kasai, Biliary surgery antibiotic prophylaxisAmber
Cefoxitin (IV)Cystic fibrosis – Pulmonary optimizationAmber
Ceftazidime (IV)Non CF bronchiectasis – Pulmonary optimizationAmber
Ceftazidime (IV)Cystic fibrosis – Pulmonary optimizationAmber
Ceftazidime (IV)Febrile neutropenia – patients with delayed type penicillin hypersensitivityAmber
Ceftazidime intravitreal injection (Ophthalmologist administration)Acute management of Open Globe Injuries (penetrating eye injury)Amber
Ceftriaxone (IV)Community acquired Sepsis (infants and children)Amber
Ceftriaxone (IV)Meningitis (infants and children)Amber
Ceftriaxone (IV)Non CF bronchiectasis – Pulmonary optimizationAmber
Ceftriaxone (IM)Ceftriaxone Intramuscular Dosing information (infants and children) – refer to AMH Children’s Dosing companion
Ceftriaxone Intramuscular dose preparation and administration – refer to RCH Paediatric injectable guidelines
Amber
Ceftriaxone (IV)Febrile non neutropeniaAmber
Ceftriaxone (IV)Salmonella bacteraemia, meningitis or osteomyelitisAmber
Ceftriaxone IV (ED HITH)Hospital-In-The-Home (HITH) Emergency/ ED pathways for Cellulitis, Community acquired pneumonia, Lymphadenitis, Peri-orbital cellulitisAmber
Cefuroxime (PO)Non CF bronchiectasis – OutpatientAmber
Cefazolin intracameral injection (Ophthalmologist administration)Acute management of Open Globe Injuries (penetrating eye injury)Amber
Cefazolin intravitreal injection (Ophthalmologist administration)Acute management of Open Globe Injuries (penetrating eye injury/ ophthalmic/ eye infections/ keratitis)Amber
Ciprofloxacin (IV)Cystic fibrosis – Pulmonary optimizationRed
Ciprofloxacin (IV)Water immersed wound infection (refer to guideline for specific indications)Red
Ciprofloxacin (PO)Cystic fibrosis – OutpatientAmber
Ciprofloxacin (PO)Non CF bronchiectasis – OutpatientAmber
Ciprofloxacin (PO)Neisseria meningitidis – prophylaxisAmber
Ciprofloxacin ear dropsOtitis externaAmber
Ciprofloxacin/ hydrocortisone ear dropsSuspected pseudomonas otitis externa with either significant canal wall oedema or associated with myringitisRed
Clarithromycin (PO)Cystic fibrosis – Non tuberculous mycobacterium (NTM)Red
Clindamycin (IV)Neonatal dosingRed
Clindamycin (PO)Cystic fibrosis – OutpatientAmber
Clindamycin (PO)Plasmodium falciparum MalariaRed
Clindamycin (PO)Mild cellulitis, peri-orbital cellulitis, impetigo, cervical lymphadenitis with nmMRSA risk factors or history of boilsAmber
Clofazimine (PO) (SAS)Cystic fibrosis – Non tuberculous mycobacterium (NTM)Red
Colistin (IV)Cystic fibrosis – Pulmonary optimizationRed
Colistin (nebulised)Cystic fibrosis – OutpatientAmber
Doxycycline (oral)Avulsion (greater than 8 years of age)Amber
Doxycycline (PO)Cystic fibrosis – OutpatientAmber
Doxycycline (PO)Water immersed wound infection (refer to guideline for specific indications)Amber
Doxycycline (PO)Plasmodium falciparum MalariaRed
Ethambutol (PO)Cystic fibrosis – Non tuberculous mycobacterium (NTM)Red
Ethambutol (PO)TuberculosisRed
Flucloxacillin (PO)Cystic fibrosis – OutpatientGreen
Flucloxacillin (PO)Mild cellulitis, peri-orbital cellulitis, impetigo, cervical lymphadenitisGreen
Flucloxacillin (IV)Neonatal dosingGreen
Flucloxacillin (IV)Burns – surgical debridement – prophylaxisGreen
Flucloxacillin (IV)Water immersed wound infection (refer to guideline for specific indications)Green
Flucloxacillin (IV)Endocarditis (prosthetic valve, nosocomial infection or community acquired MRSA suspected)Green
Flucloxacillin (IV)Osteomyelitis, Septic arthritis, moderate to severe peri-orbital cellulitis, severe cellulitisGreen
Fluconazole (IV)CHQ-GDL-01075 Antifungal Prophylaxis and Treatment in Paediatric Oncology Patients and other Immunocompromised ChildrenRed
Fluconazole (PO)CHQ-GDL-01075 Antifungal Prophylaxis and Treatment in Paediatric Oncology Patients and other Immunocompromised ChildrenAmber
Flucytosine (SAS) (PO)CHQ-GDL-01075 Antifungal Prophylaxis and Treatment in Paediatric Oncology Patients and other Immunocompromised ChildrenRed
Fusidic acid (sodium fusidate) (PO)Cystic fibrosis – MRSA - OutpatientRed
Ganciclovir (IV)Congenital CMV treatmentRed
Gentamicin antibiotic lock (CVAD)Antibiotic Lock Therapy for Catheter Related Blood Stream InfectionsAmber
Gentamicin (IV)Neonatal dosingAmber
Gentamicin (IV)Gentamicin dosing and therapeutic drug monitoring guidelineAmber
Gentamicin IV (ED HITH)Hospital-In-The-Home (HITH) Emergency/ ED pathways- Urinary tract infection/ PyelonephritisAmber
Gentamicin (IV)General Surgical antibiotic prophylaxis in patients with penicillin or cephalosporin hypersensitivity (refer to guideline for specific surgery recommendations)Amber
Gentamicin eye dropsAcute management of Open Globe Injuries (penetrating eye injury/ ophthalmic/ eye infections/ keratitis)Amber
HITH (Hospital in the home IV antimicrobials)https://qheps.health.qld.gov.au/__data/assets/pdf_file/0016/710062/hith-guide.pdfRed
Imipenem/cilastatin (IV)Cystic fibrosis – Non tuberculous mycobacterium (NTM)Red
Isoniazid (PO)TuberculosisRed
Itraconazole (PO)CHQ-GDL-01075 Antifungal Prophylaxis and Treatment in Paediatric Oncology Patients and other Immunocompromised ChildrenAmber
Itraconazole (PO)Cystic fibrosis – Allergic bronchopulmonary aspergillosis (ABPA)Amber
Lamivudine (PO)Management of newborns born to women with HIV (Human Immunodeficiency Virus) infectionRed
Lincomycin (IV)General Surgical antibiotic prophylaxis in patients with penicillin or cephalosporin hypersensitivity (refer to guideline for specific surgery recommendations)Amber
Lincomycin (IV)Water immersed wound infection (refer to guideline for specific indications)Amber
Lincomycin (IV)Cystic fibrosis – Pulmonary optimizationAmber
Lincomycin (IV)Severe/ life threatening pneumonia (PICU) (infants and children)Amber
Lincomycin (IV)Patients at risk of nmMRSA or history of boils with Osteomyelitis, Septic arthritis, moderate to severe peri-orbital cellulitis, severe cellulitisAmber
Lincomycin (IV)Suspected necrotising fasciitis (non PICU)Amber
Linezolid (PO and IV)Cystic fibrosis – Non Tuberculous Mycobacterium infection (NTM)Red
Lopinavir/ ritonavir (Kaletra) (PO)Management of newborns born to women with HIV (Human Immunodeficiency Virus) infectionRed
Mebendazole (PO)PinwormsAmber
Meropenem (IV)Febrile neutropenia – patients with anaphylaxis to beta lactamsRed
Meropenem (IV)Liver transplant – prophylaxis for patients with penicillin/cephalosporin hypersensitivityRed
Meropenem (IV)Renal transplant – prophylaxis for patients with penicillin/cephalosporin hypersensitivityRed
Meropenem (IV)Cystic fibrosis – Pulmonary optimizationRed
Meropenem (IV)External wound or inoculation with Suspected necrotising fasciitis (non PICU)Red
Metronidazole (IV)General Surgical antibiotic prophylaxis in patients with penicillin or cephalosporin hypersensitivity (refer to guideline for specific surgery recommendations)Green
Metronidazole (IV)Neonatal dosingGreen
Metronidazole (IV)Appendicitis (UNCOMPLICATED, no perforation)Green
Metronidazole (IV)CholangitisAmber
Metronidazole (PO)Clostridium difficile infection (mild/moderate)Green
Metronidazole (PO)GiardiasisGreen
Metronidazole (IV)Severe Clostridium difficile infectionGreen
Micafungin (IV)CHQ-GDL-01075 Antifungal Prophylaxis and Treatment in Paediatric Oncology Patients and other Immunocompromised ChildrenRed
Minocycline (PO)Cystic fibrosis – OutpatientAmber
Moxifloxacin (PO and IV)Cystic fibrosis – OutpatientRed
Mupirocin (intranasal ointment)Eradication of S. aureus nasal colonisation in cardiac surgery patientsAmber
Natamycin eye drops (SAS)Acute management of Open Globe Injuries (penetrating eye injury/ ophthalmic/ eye infections/ keratitis)Red
Nevirapine (PO)Management of newborns born to women with HIV (Human Immunodeficiency Virus) infectionRed
Ofloxacin eye dropsAcute management of Open Globe Injuries (penetrating eye injury/ ophthalmic/ eye infections/ keratitis)Amber
Oseltamivir (PO)CDC Recommended Dosage and Duration of Treatment or Chemoprophylaxis for Influenza Antiviral MedicationsAmber
Palivizumab (IM)RSV prophylaxis for high risk patient groupsRed
Phenoxymethylpenicillin (PO)Tonsillitis (non PICU)Green
Piperacillin/ Tazobactam (IV)Liver transplant – prophylaxisAmber
Piperacillin/ Tazobactam (IV)Renal transplant – prophylaxisAmber
Piperacillin/ Tazobactam (IV)Febrile neutropeniaAmber
Piperacillin/ Tazobactam (IV)Cystic fibrosis pulmonary optimizationAmber
Piperacillin/ Tazobactam (IV)Non CF bronchiectasis – Pulmonary optimizationAmber
Piperacillin/ Tazobactam (IV)Appendicitis COMPLICATED (e.g. perforation, appendiceal collection / abscess), Peritonitis, Necrotising enterocolitisAmber
Piperacillin/ Tazobactam (IV)Compound fractures - Open fractures – severe tissue damage/ evidence of infectionAmber
Posaconazole (IV)CHQ-GDL-01075 Antifungal Prophylaxis and Treatment in Paediatric Oncology Patients and other Immunocompromised ChildrenRed
Posaconazole (PO)CHQ-GDL-01075 Antifungal Prophylaxis and Treatment in Paediatric Oncology Patients and other Immunocompromised ChildrenAmber
Primaquine (PO)Malaria – Plasmodium ovale and Plasmodium vivax (note: different dosing recommendations – check carefully)Red
Pyrazinamide (PO) (SAS)TuberculosisRed
Quinine sulfate (SAS) (PO)Plasmodium falciparum MalariaRed
Rifampicin (PO)Cystic fibrosis – MRSA - OutpatientAmber
Rifampicin (PO)Neisseria meningitidis – prophylaxisAmber
Rifampicin (PO)TuberculosisRed
Taurolidine/citrate antiseptic lock (Taurolock)Use of Taurolidine/Citrate Lock Solution in the Prevention of Central Venous Catheter Related BacteraemiaRed
Teicoplanin (IV)Cystic fibrosis – MRSA – Pulmonary optimizationAmber
Teicoplanin (IV)CHQ-PROC-03455 Management of Compromised Central Venous Access Device (CVAD)Amber
Terbinafine (PO)CHQ-GDL-01075 Antifungal Prophylaxis and Treatment in Paediatric Oncology Patients and other Immunocompromised ChildrenAmber
Tetanus containing vaccineTetanus prone woundGreen
Tigecycline (IV)Cystic fibrosis – Non Tuberculous Mycobacterium infection (NTM)Red
Tobramycin (inhaled – TOBI podhaler)Cystic fibrosis - OutpatientAmber
Tobramycin (IV)Neonatal dosingAmber
Tobramycin (IV)Cystic fibrosis pulmonary optimizationAmber
Tobramycin (TOBI nebulised)Cystic fibrosis - OutpatientAmber
Tobramycin (TOBI nebulised)Non CF Bronchiectasis - OutpatientAmber
Trimethoprim / Sulfamethoxazole (PO)Water immersed wound infection (refer to guideline for specific indications)Green
Trimethoprim/ Sulfamethoxazole (IV)Cystic fibrosis – MRSA – Pulmonary optimizationAmber
Trimethoprim/ Sulfamethoxazole (PO)Cystic fibrosis – MRSA/ severe infection – OutpatientAmber
Trimethoprim/ Sulfamethoxazole (PO)Non-typhoidal Salmonellosis in ChildrenAmber
Trimethoprim/ Sulfamethoxazole (PO)Mild cellulitis, peri-orbital cellulitis, impetigo, cervical lymphadenitis with nmMRSA risk factors or history of boilsGreen
ValGANciclovir (PO)Renal transplant – CMV prophylaxisAmber
ValGANciclovir (PO)Congenital CMV treatmentAmber
Vancomycin antibiotic lock (CVAD)Antibiotic Lock Therapy for Catheter Related Blood Stream InfectionsAmber
Vancomycin (IV)Vancomycin dosing and Therapeutic drug monitoring guideline (check indication for dosing and monitoring guidance)Amber
Vancomycin (IV)Neonatal dosingAmber
Vancomycin (SAS) (PO)Clostridium difficile infection (moderate/severe)Red
Vancomycin intravitreal injection (Ophthalmologist administration)Acute management of Open Globe Injuries (penetrating eye injury/ ophthalmic/ eye infections/ keratitis)Amber
Vancomycin intracameral injection (Ophthalmologist administration)Acute management of Open Globe Injuries (penetrating eye injury/ ophthalmic/ eye infections/ keratitis)Amber
Voriconazole eyedropsAcute management of Open Globe Injuries (penetrating eye injury/ ophthalmic/ eye infections/ keratitis)Red
Voriconazole (IV)CHQ-GDL-01075 Antifungal Prophylaxis and Treatment in Paediatric Oncology Patients and other Immunocompromised ChildrenRed
Voriconazole (PO)CHQ-GDL-01075 Antifungal Prophylaxis and Treatment in Paediatric Oncology Patients and other Immunocompromised ChildrenAmber
Voriconazole Intravitreal injection (Ophthalmologist administration)Acute management of Open Globe Injuries (penetrating eye injury/ ophthalmic/ eye infections/ keratitis)Red
Zidovudine (SAS) (IV)Management of newborns born to women with HIV (Human Immunodeficiency Virus) infectionRed
Zidovudine (PO)Management of newborns born to women with HIV (Human Immunodeficiency Virus) infectionRed