Antibiotic -Background. -if the age of less than one year. w = age (ms) +9 % years weight better.

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1 Dr.Wahid Helmy Rifahie Antibiotic -Background First: Calculate the weight: -if the age of less than one year. w = age (ms) +9 % years weight better. Second: If the drug concentration, for example, 125 mg means that every 5 cm 3 of medication containing 125 mg of the drug. Thirdly: pecks used in calculation:- Tea - Spoon 3.5 cm3, table - Spoon 7.5 cm3, antibiotic- Spoon 5-10 cm. Fourth: To calculate the dose:- Quantity / day = The wanted Quantity / day in mg 5) Drug concentration. Fifth: Antibiotics dos is usually between mg / kg / day. Sixth: pediatrician must have small calculator to calculate doses. Seventh: There are no so-called prophylactic antibiotics except in special cases only. Eighth: If you start the course of treatment by injection and decided to move to the syrup must be the same type Anti-biotic. NB. 90% of the diseases caused by viral infection, Must not rush to give antibiotics To differentiate between viral infection and the bacterial Depends on four things: Bacterial: Fever Between 38.5 and 39, week Activity, poor Suckling power & Toxemia may be present. Viral: Either v.high 40 or low grade 38.2 Fever, normal Activity, normal should we follow up all cases after 48 hours Suckling powerabsent oxemia.

2 Dr.Wahid Helmy Rifahie (1) Penicillin: i. Penicillin G (crystalline P.) Mainly against Gm + ve as strept. And staph. dose:: 50 thousand thousand units / kg / day, divide the dose every 6 hours and in newborns every 12 hours. dose can be up to 300 thousand units / kg in dangerous situations such as meningitis. ii. Penicillin V: (only oral). Dose: 50 thousand thousand units / kg / day like ( OSPEN400) syrup taken every 6 hours. iii. Benzathine Penicillin: (injection IU): - Taken every two weeks. Sensitivity test is made every time taken. Dosage: - Less than 3 years 1/4 of the syringe. Up to 9 years of age or weight of more than 27 kg half of the syringe. Above 27 kg weight the syringe. 2) Amoxicillin: - Used in U.R.T.I cases, O.M. Sinusitis. Dose: mg / kg / day divided every 8 hours. a) Amoxicillin 125, 250 susp. b) Amoxicid 125, 250 susp. c) E-mox 125,250 susp. * 0.25, 0.5, 1 gm i.v. d) Biomox (80ml) susp. e) Ibiamox( (80ml) 200, 400 susp. f) Amoxil 125, 250 susp. * 0.5, 1 gm i.v. g)hiconcil (oral drops) 100 mg/1cm3.

3 (3)Amoxacilline and clavulinic acid: - Deltaclav mg susp. Hibiotic: mg susp. - Hibiotic mg tab Dr.Wahid Helmy Rifahie Example: 11 kg child needsc in each dose of 20 x 11 = 220 in each dose so he takes (5 cm)/ dose of concentration of 230mg/8 hour. To facilitate, use of the following rule only in this group If the child is less than 8 kg takes (5 cm) of a concentration of 156 mg / 8 h. If the child is kg takes 5cc of concentration of 230 mg / 8 hours of If the child is kg takes 3.5 cm concentration of 460 mg / 8 hours kg takes 4 cm from the concentration of 460 mg / 8 hours - 20 kg takes 5cc from a concentration of 460 mg / 8 hours (4) Ampicillin: - The common dose of antibiotics mg / kg / day, must be given every 6 or 8 hours. Trade names.r / Ampicillin vial & Epicocillin susp. & R / gm In the case of meningitis double dose mg / kg / day. (5) Ampicillin and sulbactam: -- Trade names.ampictam Segmafen- Unictam- Unasyn. syrup they is present in only one concentration of 250 mg. ( Dose of the syrup is 50 mg / kg / day or an easier 1 cm / kg / day/ 8 or 12h). injection is present in concentrations of 375, 750 and 1500 mg (dose for the injection of mg / kg / day). (6) Cephalosporin: A. 2nd generation: Cefuroxime Zinnat (250mg/vial و gm/vial gm/vial, & 125mg :Susp).Dose of the syrup 20 mg / kg / day in two divided doses mean / 12 hour dose injection of 50 mg / kg / day also / 12 hours. 2-Cefaclor: Against Gm + ve &-ve and micro plasma. - Dose of mg / kg / day. - Must be divided in 3 doses (mean 10 mg / k / dose). - Concentrations of 125 and 250 mg syrup only. - Names in the market such as Bacticland Cefaclor.

4 .3 - Cefprozil: cefzil 125, 250 mg/ 5ml Dr.Wahid Helmy Rifahie Taken in cases of otitis media only. NB: 2nd generation cephalosporin's used as, 1st line in O.M &Pharyngitis&2nd line if no response to amoxicillin. In 2-3 ms babies. B. 3rd generation: In injection form only - mainly GM-ve. Months of species in this group are as follows 1 - Cefotaxime: -:- Cefotax & Ramitax - Xorine Ceforan- Claforan -Dose of mg / kg / day in infancy. - Is present in conc., of 0.25, 0.5, 1 gm. 2- Cefoperazone Sodium: (Cefobid-Cefzone - Cefazone - (Cefoperazone (T3A) - Dose as before, Used in the. CHILDREN. - The same dose as stated above., Concentrations of 0.5 and 1 g. 3- Ceftazidine: ( fortum ) - The same dose as stated above.- Conc., of 0.5 and1 g. 4- Cefotraixone 0.5 and 1 gm. - Cefaxone 0.25 & 0.5 & 1gm. Dose of mg / kg / day. - Preferably postponed for the cases. resistant 5-Cefixime: - -Only one in this group, which is taken orally. -Dose of 8 mg / kg / day and a single daily dose is taken -But may be taken, in two doses, or 4 mg / k / 12 hours. - In cases of U.T.I & Typhoid & salmonella inection& Mild to moderate chest infection. - Each 5 cm = 100 mg (for example, a child weighing 10 kg.) Quantity = 2 cm / 12 Hours /mouth. The method of calculating the doses of injections: Equation is as follows: the quantity to be administered / day ml. = Quantity in mg in single dose x amount of ampoule or quantity that will vial be diluted / concentration. And divide the dose / 8 hours. When given by IM injection underestimate theamount of the. solvent (2 or 3cm) and divide the dose / 12 Hours.

5 Example (1: 10kg baby will take from cefotax 1gm, im. ( Dose (10 100) /day)/ 12h / 3ml vial dilution. If when we render in the equation: - Quantity day = 1.5 cm / 12 hours. - Quantity per day = 1.5 cm / 8 hours. Example (2: 6 kg baby case mild the cefotax IV 500mg vial. Needy in today's = 600 mg from 500 mg vial remains.quantity = 2 cm / 8 hours I.V. Example (3: Baby weighing 5 kg, mild status from cefotax IM Daily dose 5 x 100 = 500 mg from cefotax IM 500 Quantity = 1 cm / 12 hour IM. Examples of ceftriaxone (single daily dose) Example (4: Example (5: Child 15 kg needs in the day to 50 x 15 = 750 mg per day from 1000 mg (1gm) im. The quantity = 2.25 cm / day IM Dr.Wahid Helmy Rifahie Baby weighing 9 kg needs 9 x 50 = 450 mg per day from 500 mg im The quantity = 2.5 cm / day IM. (7) Amino glycosides:- - Against Gm-ve (SE: OTOTOXIXITY & NEPHROTOXICITY). -The most famous types: Gentamycin: - dose of mg / kg / day in infancy - Dose of 2.5 mg / kg / 12 hours in neonates. - Dose / 12 Hours - if i.m, and / 24 Hours. i.v. - The most famous names in the market: # Garamycin ampoule 20, 80 mg (2 cm) & 40 mg (1cm). # Gentamycin ampoule 80 mg (2cm). # Apigent vial 80 mg (2cm) Example: A child weighing 10 kg Quantity = 1 cm / 12 Hours Muscle - Example: baby weighed 6 kg Quantity = 2 cm / 12 Hours Muscle Amikacin: - Is present in concentrations of 100, 250, 500 mg, all Vial 2 cm - Dose of 15 mg / kg / day IM or IV

6 Dr.Wahid Helmy Rifahie Tobramycin: R/Tobrine / 20 & 80mg/ vial. like gentamicin in everything. least side effects of this group. ( 8) Macrolides: 1st generation (Erythromycin): dose of mg / kg / day. to be given every 8 hours. every 5 cm = 200 mg. taken half an hour before eating or two hours after eating (on empty stomach) the most famous names in the market:- Erythrocine. Erythromycin. 2nd generation (Klarithromycin): dose of 15 mg / kg / day. divides every 12 hours. the most famous names, Klacid 125, 250 mg 3rd generation (Azithromycin): dose of 10 mg / kg / day. given every 24 hours. the most famous names, Zithromax. Zithrokan. Zithrocin. exist in concentrations of 100 mg (dose weight / 2). And 200 mg (dose= weight / 4). N.B: Macrolides are Gm + ve static Used mainly in: - Mycoplasma pneumonia & a febrile pn. - Prolonged cough not responding to drugs (9) Sulpha + Trimethoprim: dose of 1 cm / kg / day divided twice daily most famous names in the market: Septrin susp. - Septazole susp. used in cases of: - U.T.I. - Salmonella. - E.coli

7 (10) Quinolones Dr.Wahid Helmy Rifahie they believed was not used less than 18 years old because they retard the growth of bones and found that it only in animals.( Trade names)., Ciprobay tab mg. - Cipro tab 500 mg. - Ciprofloxacin tab mg. dose of 10 mg / kg / day in Neonates. And mg / kg / day for infants and children. The last type is ofloxacin and forbidden to use as a syrup or tablets for children or DVD, but is only possible use in the form of ointments, eye and ear drops. This group is often used in UTI and also Giti. (11) Nitrofurantoine: dose of 5-7 mg / kg / day Months example is uvamine retard cap. Each 100 mg capsule One of the best medicines that starts by treating UTI May cause vit.b.

8 Dr.Wahid Helmy Rifahie (12) Tetracycline: No less than 8 years side effects such as delay in the growth of teeth and colored. dose of 5-7 mg / kg / day. (13) Chloramphenicol: forbidden in children, especially for less than 5 years of age makes an aplastic anemia. How to choose antibiotics 1) In U.R.T.I (pharyngitis &tonsillitis) Start with: a- Amoxicillin then, b- Amox. &clav. Then, c- 1st gen.cephalosp. then, d-2ndgen.cephalosp. 2) In chest infections start with: a- Amox. &clav. then b- 2nd gen.cephalosp. then 3) In G.I.iTis only if bacterial start with: a- Septrin then b- 1st gen. cephalosp. then 4) U.T.I start with: a- Uvamine then b- Septrin then c- 3rd gen. cephalosp. then c- Ceftaxim(injection) then d- Quinolons ( if older) c- 3rd gen. cephalosp. then d-quinolones 5) In skin infections use: 6) In osteomyelitis use: a- Macrolides b- 1st &2nd gen. cephalosporin Anti-staph.:- Floxacillin & cloxacillin 7) Typhoid use: a- Septrin then b- Cefotriaxone then c- Cefotaxime then d- Quinolones