Urinary tract infection (UTI)

Uncomplicated UTI

Trimethoprim/ Sulfamethoxazole oral 4mg/kg/dose orally twice daily (Max 160mg/dose Trimethoprim component) for 5 days.

UTI and less than 3months of age – Treat as for PYELONEPHRITIS. Refer to Ampicillin/ Amoxycillin & Gentamicin neonatal dosing section

Pyelonephritis (PICU and non PICU)

Ampicillin (or Amoxycillin) IV

Neonates: Refer to Ampicillin/Amoxycillin neonatal dosing section

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

 

PLUS Gentamicin IV

Neonates: Refer to Gentamicin neonatal dosing section

If more than 1 month of age and less than 10 years old: 7.5mg/kg IV once daily (Max 320mg for initial dose.

If more than 10 years of age: 6mg/kg IV once daily (max initial dose of 560mg/day)

Seek ID advice within 72 hours.

If gram negative and resistant to Ampicillin/Amoxycillin – consult ID team for advice

If Immediate or delayed hypersensitivity to penicillins, use Gentamicin IV as single agent initially and seek ID advice within 72 hours.

Comments:
Seek pharmacist/ID advice on appropriate therapeutic drug monitoring (TDM) and appropriate dosing for patients in renal failure.

Paediatric Tobramycin/Gentamicin Therapeutic drug monitoring.

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