Pediatric Antibiotic Dosing - Pneumonia

Snippets to calculate doses for antibiotics used for treating pneumonia in pediatric patients
(as per Bugs and drugs and RxFiles)

Amoxicillin:

{note: trim=yes}
PNA - Amoxicillin
Dose: {formmenu: 40; 45; 50; 55; 60; 65; 70; 75; 80; 85; 90; name=menu_conc} mg/kg/day
-- Higher doses (75-90mg/kg/d) cover the majority of penicillin resistant Streptococcus pneumoniae
-- Consider if: Daycare, ABX within previous 3 mos, failure of initial treatment
Weight: {formtext: name=weight} kg
Ref: Bugs and Drugs
{endnote: trim=no}
{note: trim=yes; preview=no}
{conc=menu_conc}
{daily_dose=weight * conc}
{if: daily_dose > 4000}{dose=4000}{else}{dose=daily_dose}{endif}{endnote}
Amoxicillin 40-90 mg/kg/day PO ÷ TID x 5 days (max 4 g/day)
Weight: {=weight} kg

Rx: Amoxicillin {=dose / 3; format=,.0f} mg PO TID x 5 days

Azithromycin:

{note: trim=yes}
PNA - Azithromycin
Weight: {formtext: name=weight}kg
-- Add clindamycin if: lobar pneumonia with fever or rigors, antibiotic therapy within previous 3 months, local S. pneumoniae macrolide resistance > 15%
Ref: Bugs and Drugs
{endnote}
Azithromycin 10mg/kg po Day 1 (max 500 mg/dose), then 5mg/kg po daily x 4 days (max 250mg/day)
Weight: {=weight} kg
Day 1 Dose: {=d1_dose} mg
Day 2-5 Dose: {=d2_5_dose} mg
{note: trim=yes; preview=no}
{if: weight * 10 > 500}{d1_dose=500}{else}{d1_dose=10 * weight}{endif}
{if: weight * 5 > 250}{d2_5_dose=250}{else}{d2_5_dose=5 * weight}{endif}
{endnote}

Clarithromycin:

{note: trim=yes}
PNA - Clarithromycin
Weight = {formtext: name=weight} kg
-- Add clindamycin if: lobar pneumonia with fever or rigors, antibiotic therapy within previous 3 months, local S. pneumoniae macrolide resistance > 15%
Ref: Bugs and Drugs
{endnote}
{note: preview=no; trim=yes}
{daily_dose=weight * 15}
{if: daily_dose > 500}{dose=500}{else}{dose=daily_dose}{endif}
{endnote: trim=no}
Clarithromycin 15mg/kg/day ÷ BID x 5 days (max 500mg/day)
Weight: {=weight} kg

Rx: Clarithromycin {=dose / 2; format=,.0f} mg PO BID x 5 days

Cefuroxime:

{note: trim=yes}
PNA - Cefuroxime
Dose: {formmenu: 20; 25; 30; name=conc}
Weight: {formtext: name=weight} kg
Ref: RxFiles
{endnote}
{note: trim=yes; preview=no}
{daily_dose=conc * weight}
{calc_dose=daily_dose / 2}
{if: calc_dose > 500}{dose=500}{else}{dose=calc_dose}{endif}
{endnote}
Cefuroxime 20-30mg/kg/day po ÷ BID x 7-10 days (max 500mg/dose)
Weight: {=weight} kg

Rx: Cefuroxime {=dose; format=,.0f}mg PO BID x 7-10 days

Clindamycin:

{note: trim=yes}
PNA - Clindamycin
Weight = {formtext: name=weight} kg
Dose: {formmenu: 20; 25; 30; 35; 40; name=conc}
Ref: Bugs and Drugs
{endnote}
{note: preview=no; trim=yes}
{daily_dose=weight * conc}
{if: daily_dose > 1800}{dose=1800}{else}{dose=daily_dose}{endif}
{endnote: trim=no}
Clindamycin 20-40mg/kg/d PO ÷ TID x 5 days (max 1800mg/day)
Weight: {=weight} kg

Rx: Clindamycin {=dose / 3; format=,.0f} mg PO TID x 5 days

Doxycycline:

{note: insert=no; trim=yes}
PNA - Doxycycline
Weight: {formtext: name=weight} kg
Duration: {formmenu: default=5 days; 7-10 days; name=duration}
-- Bugs and drugs = x 5 days
-- RxFiles = x 7-10 days
Note: Only use in patients ≥8 years old
Ref: Bugs and Drugs & RxFiles
{endnote}
{note: preview=no; trim=yes}
{weight_dose=weight * 4}
{if: weight_dose > 200}{daily_dose=200}{else}{daily_dose=weight_dose}{endif}
{dose=daily_dose / 2}
{endnote}
Doxycycline 4mg/kg/d PO div BID x {=duration} (maximum 200mg/day)
Weight: {=weight} kg

Rx: Doxycycline {=dose} mg PO BID x {=duration}

Clavulin:

{note: trim=yes}
PNA - Clavulin
Weight = {formtext: name=weight} kg
Note: Dose based on amoxicillin component, use 7:1 formulation (400mg/57mg per 5mL)
Ref: Bugs and Drugs
{endnote: trim=no}
{note: trim=yes; preview=no}
{daily_dose=weight * 45}
{if: daily_dose > 3000}{dose=3000}{else}{dose=daily_dose}{endif}
{endnote}
Amoxicillin-clavulanate 45mg/kg/d PO div TID x 5 days (maximum 1 g TID of amoxicillin)
Weight = {=weight} kg

Rx: Amoxicillin-clavulanate {=dose / 3; format=,.0f} mg PO TID x 5 days

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