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Recommendations for treatment of dysentery 4.15
Antibiotics for treatment of dysentery
a Children with diarrhoea and blood in stool i.e. dysentery should be treated with ciproloxacin as a irst line treatment. Cetriaxone should be given as a second
line treatment in severely ill children where local antimicrobial sensitivity is not known.
— Ciproloxacin: 15 mgkgdose twice daily for 3 days — Cetriaxone: 50–80 mgkg daily for 3 days
Strong recommendation, low quality evidence
b Where local antimicrobial sensitivity is known, local guidelines should be followed.
Strong recommendation, low quality evidence
Recommendations for treatment of common causes of fever 4.16
Antibiotics for treatment of acute bacterial meningitis
a Children with acute bacterial meningitis should be treated empirically with 3rd generation cephalosporins.
— Cetriaxone: 50mgkg per dose IV every 12 hours or 100 mgkg once daily, or — Cefotaxime: 50mgkg per dose every 6 hours for 10–14 days.
Strong recommendation, moderate quality of evidence
b Where it is known that there is no signiicant resistance to chloramphenicol and beta lactam antibiotics among bacteria-causing meningitis follow national
guidelines or choose any of the following two regimens: — Chloramphenicol: 25 mgkg IM or IV every 6 hours plus ampicillin: 50 mg
kg IM or IV every 6 hours OR
— Chloramphenicol: 25 mgkg IM or IV every 6 hours plus benzyl penicillin: 60 mgkg 100 000 unitskg every 6 hours IM or IV.
Conditional recommendation, moderate quality evidence
4.17 Antibiotics for treatment of acute otitis media
a Children with acute otitis media should be treated with oral amoxicillin at 40 mg kg twice per for 7–10 days.
Strong recommendation, low quality evidence
b Where pathogens causing acute otitis media are known to be sensitive to co- trimoxazole, this antibiotic could be used as an alternative given twice per day for
7–10 days.
Strong recommendation, low quality evidence
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4.18 Topical antibiotics for treatment of chronic suppurative otitis
media CSOM
a Children with chronic suppurative otitis media CSOM should, in addition to aural toilet by dry wicking, be treated with instillation of drops containing qui-
nolones such as ciproloxacin, norloxacin, oloxacin three times daily for two weeks.
Strong recommendation, low quality evidence
b Children who fail to respond to treatment should be referred for further evaluation for other causes of CSOM, especially tuberculosis.
Strong recommendation, expert opinion
4.19 Topical antiseptics for treatment of chronic suppurative otitis
media
Topical antiseptics and steroids should not be used for the treatment of CSOM in children.
Strong recommendation, low quality evidence
4.20 Topical steroids for treatment of chronic suppurative otitis media
Topical steroids should not be used in treating CSOM.
Weak recommendation, very low quality evidence
4.21 Antibiotics for treatment of Typhoid Fever
a Children with typhoid fever should be treated with a luoroquinolone i.e. Ciproloxacin, Gatiloxacin, Oloxacin, and Perloxacin as a irst line treatment
for 7–10 days. — Ciproloxacin: orally 15 mgkgdose twice daily for 7–10 days.
Strong recommendation, moderate quality evidence
b If the response to treatment is poor, consider drug-resistant typhoid, and treat with a second line antibiotic like 3rd generation cephalosporins or azithromycin.
— Cetriaxone IV: 80 mgkg per day for 5–7 days, OR
— Azithromycin: 20 mgkg per day for 5–7 days.
Strong recommendation, moderate quality evidence
c Where drug resistance to antibiotics among salmonella isolates is known, follow the national guidelines according to local susceptibility data.
Strong recommendation, moderate quality evidence
