Ear, nose and throat (ENT) infections

Acute otitis media

Amoxycillin oral 25 mg/kg (Max 1gram/dose) every 8 hourly for 5 days
For delayed type hypersensitivity (eg. rash) to penicillins, use oral Cephalexin 30mg/kg/dose (Max 1gram/dose) every 8 hourly for 5 days.
Comments:
For more information, refer to CHQ-GDL-00710 Acute Otitis Media: Emergency Management in Children guideline and CHQ-GDL-01202 Paediatric Antibiocard: Empirical Antibiotic Guidelines

Mastoiditis

Cefotaxime IV

Neonates: Refer to Cefotaxime neonatal dosing section

If more than 1 month of age: 50mg/kg (Maximum 2gram/dose) IV every 6 hourly

Seek ID review within 72 hours.

For immediate type hypersensitivity to cephalosporins, seek ID advice for alternative antibiotic choice.
Comments:
For more information, refer to CHQ-GDL-01202 Paediatric Antibiocard: Empirical Antibiotic Guidelines

Otitis externa

For more information, refer to:

Tonsillitis

Phenoxymethylpenicillin oral 15mg/kg (Max 500mg/dose) twice daily for 10 days.
For delayed type hypersensitivity (eg. rash) to penicillins, use oral Roxithromycin 4mg/kg/dose (Max 150mg/dose) twice daily for 10 days

Comments:

For more information, refer to CHQ-GDL-01202 Paediatric Antibiocard: Empirical Antibiotic Guidelines

Retropharyngeal abscess

IV Amoxicillin-Clavulanic acid

Neonates and Infants (0 to 3 months)

  • If <4kg: 25mg/kg/dose (amoxicillin component) every 12 hours
  • If >4kg: 25mg/kg/dose (amoxicillin component) every 8 hours

Infants and children (>3 months)

Severe infection: 25mg/kg/dose (amoxicillin component) every 6 hourly (Max 1000mg/dose Amoxicillin component)

Adolescents >12 years (and >40kg):

Severe infection: 25mg/kg/dose (amoxicillin component) every 6 hourly (Max 2000mg/dose Amoxicillin component)

Seek ID review within 24 hours

For delayed type hypersensitivity,

Cefotaxime IV

Neonates: Refer to Cefotaxime neonatal dosing section

If more than 1 month of age: 50mg/kg (Max 2gram/dose) IV every 6 hourly

Seek ID review within 24 hours.

Comments:

For more information, refer to CHQ Paediatric Antibiocard: Empirical Antibiotic Guidelines
and the
Paediatric Medication Guideline – Intravenous Amoxicillin-Clavulanic acid (QH staff only)

Contact us

ID fellow/ID registrar t: 07 3068 1111 (via Queensland Children’s Hospital, (QCH) switchboard) e: CHQ_IMPS@health.qld.gov.au AMS Pharmacist t: 0436 815 492 e: Antibiotics_CHQ@health.qld.gov.au

Quick links

CHQ-GDL-01202 CHQ Paediatric Antibiocard: Empirical Antibiotic Guidelines

CHQ-GDL-01064 CHQ Paediatric surgical antibiotic prophylaxis guidelines

CHQ-GDL-01070 Paediatric Cardiac Surgical Antibiotic Prophylaxis

CHQ-GDL-01066 Empiric Antibiotic Guidelines for Paediatric Intensive Care Unit (PICU)

CHQ-GDL-01073 Empirical antimicrobial therapy for children with Cystic Fibrosis

CHQ-GDL-01072 Empirical antimicrobial therapy for children with Non-Cystic Fibrosis Bronchiectasis

Seasonal Influenza Vaccine 2019 Memorandum (QH staff only)

CHQ Memorandum Trimethoprim – sulfamethoxazole shortage (QH staff only)

Azithromycin 500mg injections shortage – CHQ Medication Communique (QH staff only)

Antibiotic awareness – information for families and patients

What every parent should know about coughs, colds, earaches and sore throats

Antibiotic resistance: the facts

NPS Antibiotic resistance website

Queensland Specialist Immunisation service

Individual patient approval form (QH staff only)