Intravenous agent | Dose for infants 8 to 28 days of age | Dose for children >28 days of age |
Ampicillin | 150 mg/kg per day IV divided in 2 doses | 200 to 400 mg/kg per day IV divided in 4 doses; maximum dose 12 g/day |
Cefazolin | 100 to 150 mg/kg per day IV divided in 3 doses | 100 to 150 mg/kg per day IV divided in 3 doses; maximum dose 6 g/day |
Cefepime | 60 to 100 mg/kg per day IV divided in 2 doses | 100 to 150 mg/kg per day IV divided in 3 doses; maximum dose 6 g/day |
Cefotaxime | 150 to 200 mg/kg per day IV divided in 3 doses | 150 to 200 mg/kg per day IV divided in 3 or 4 doses; maximum dose 8 g/day |
Ceftazidime | 150 mg/kg per day IV divided in 3 doses | 125 to 150 mg/kg per day IV divided in 3 doses; maximum daily dose 6 g |
Ceftriaxone | 50 to 75 mg/kg per day IV in 1 dose | 75 to 100 mg/kg per day IV divided in 1 or 2 doses; maximum dose 4 g/day |
Clindamycin | 20 to 30 mg/kg per day IV divided in 3 doses | 25 to 40* mg/kg per day IV divided in 3 or 4 doses; maximum dose 2.7 g/day |
Daptomycin¶ | NA | 1 through 6 years: 12 mg/kg per day IV in 1 dose 7 through 11 years: 9 mg/kg per day IV in 1 dose 12 through 17 years: 7 mg/kg per day IV in 1 dose |
Gentamicin | 7.5 mg/kg per day IV divided in 3 doses | 7.5 mg/kg per day IV divided in 3 doses |
Linezolid | 30 mg/kg per day IV divided in 3 doses | <12 years: 30 mg/kg per day IV in 3 doses ≥12 years: 600 mg twice per day IV |
Nafcillin | 100 mg/kg per day divided in 4 doses | 150 to 200 mg/kg per day IV divided in 4 doses; maximum dose 12 g/day |
Oxacillin | 100 mg/kg per day IV divided in 4 doses | 150 to 200 mg/kg per day IV divided in 4 to 6 doses; maximum dose 12 g/day |
Penicillin | 150,000 units/kg per day IV divided in 3 doses | 250,000 to 400,000 units/kg per day IV divided in 4 to 6 doses; maximum dose 24 million units per day |
VancomycinΔ | Loading dose of 20 mg/kg IV followed by maintenance dose according to serum creatinine as indicated below. The interval between the loading dose and the first maintenance dose should be the same as the dosing interval for the maintenance regimen. This dosing regimen was designed with a target trough concentration of 5 to 10 mg/L.[1]
| Refer to UpToDate content related to alternative methods of dosing vancomycin for children older than 28 days◊ |
IV: intravenous; NA: not available; PMA: postmenstrual age; PNA: postnatal age; AUC: area under the curve.
* 40 mg/kg per day is preferred for children ≥3 months of age.
¶ Daptomycin should not be used in children with concomitant pulmonary involvement and is not recommended in children <1 year of age because of the risk of potential effects on muscular, neuromuscular, and/or nervous systems (peripheral and/or central) observed in dogs. It is not approved for the treatment of osteoarticular infections in children; the appropriate dose for osteoarticular infections has not yet been established but is the subject of clinical trials. The doses provided above are those that are recommended for Staphylococcus aureus bacteremia in children.
Δ Dosing algorithm for vancomycin based upon serum creatinine concentration in neonates born at gestational age >28 weeks. A vancomycin dosing method based upon PMA and PNA is provided as an alternative to the serum creatinine-based method listed above and may be useful in some clinical situations.[2] The regimen was designed with a target trough concentration of 10 to 20 mg/L.
◊ The approach to vancomycin dosing is generally determined at the institutional level. Refer to UpToDate content on invasive staphylococcal infections in children for details of trough-guided and AUC-guided vancomycin dosing.
Data adapted from: American Academy of Pediatrics. Tables of antibacterial drug dosages. In: Red Book: 2021-2024 Report of the Committee on Infectious Diseases, 32nd ed, Kimberlin DW, Barnett ED, Lynfield R, Sawyer MH (Eds), American Academy of Pediatrics, Itasca, IL 2021. p.876.
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