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:

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.

Otitis externa

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

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.