Which medications in the drug class Antibiotic Agents are used in the treatment of Pediatric Pneumococcal Infections?

Updated: Jan 14, 2019
  • Author: Meera Varman, MD; Chief Editor: Russell W Steele, MD  more...
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Answer

Antibiotic Agents

Empiric antimicrobial therapy must be comprehensive and should cover all likely pathogens in the context of the clinical setting.

Amoxicillin (Trimox, Amoxil, Biomox)

DOC for OM, sinusitis, and outpatient treatment of pneumonia. Interferes with synthesis of cell wall mucopeptides during active multiplication resulting in bactericidal activity against susceptible bacteria.

Ceftriaxone (Rocephin)

Third-generation cephalosporin. DOC for meningitis (age >1 mo), inpatient treatment of pneumonia, occult bacteremia, and other invasive infections. Alternative for outpatient treatment of occult bacteremia and OM unresponsive to standard antibiotics.

Cefotaxime (Claforan)

Third-generation cephalosporin. DOC for meningitis (all ages), inpatient treatment of pneumonia, bacteremia, and other invasive infections.

Vancomycin (Vancocin)

DOC for initial treatment of all meningitis (with cefotaxime or ceftriaxone) until susceptibilities are known. Continue in addition to ceftriaxone if the organism's ceftriaxone MIC is >0.25 mcg/mL. Also consider adding for non-CNS invasive infections if not responding to standard treatment because the infection may be caused by highly penicillin-resistant strains. DOC for patients allergic to penicillin with meningitis (with rifampin) or other invasive infections (alone).

Azithromycin (Zithromax)

Alternative for patients allergic to penicillin with OM, sinusitis, or outpatient treatment of pneumonia.

Clindamycin (Cleocin)

Alternative treatment for OM or sinusitis unresponsive to standard treatment. Alternative also for OM, sinusitis, and inpatient or outpatient treatment of pneumonia and treatment of invasive infections other than CNS infections in patients who are allergic to penicillin.

Meropenem (Merrem IV)

A carbapenem antibiotic alternative for patients allergic to penicillin with meningitis or other severe invasive infections (good CSF penetration). Has been used successfully in patients with meningitis caused by penicillin-resistant pneumococci.

Rifampin (Rifadin)

Used in conjunction with vancomycin for patients allergic to penicillin with meningitis.

Amoxicillin-clavulanic acid (Augmentin)

Antibiotic with beta-lactam inhibitor. Alternative for OM or sinusitis unresponsive to standard treatment.

In children ≥ 3 mo, base dosage protocol on amoxicillin content. As a result of different amoxicillin–to–clavulanic acid ratios in 250-mg tab (250/125) vs 250-mg chewable tab (250/62.5), do not use 250-mg tab until child weighs >40 kg.

Cefprozil (Cefzil)

Alternative for OM or sinusitis unresponsive to standard treatment or in patients with penicillin allergy but no cephalosporin allergy. Alternative outpatient treatment for pneumonia.

Cefepime (Maxipime)

Fourth-generation cephalosporin with good gram-negative coverage. Similar to third-generation cephalosporins but has better gram-positive coverage. Has good pneumococcal coverage and penetrates the CSF well, thus, can be used as alternative to ceftriaxone.

Cefuroxime (Zinacef, Ceftin)

Second-generation cephalosporin good for treatment of non-CNS pneumococcal disease


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