WCH / Pediatrics Pharmacy Department Pediatric Dosing Recommendations University of Missouri Health Care Acyclovir (Zovirax) - IV for HSV Encephalitis Neonates-11 years: 20 mg/kg/dose q8 hrs x 14-21 days ≥ 12 years: 10-15 mg/kg/dose q8 hrs x 14-21 days **Maximum: 2 grams/dose Cefazolin (Kefzol) - IV Neonates: 25 mg/kg/dose 37-44 weeks: 0-7 days q12 hrs   > 7 days q8 hrs Infants (≥ 45 weeks) and children: 25 mg/kg/dose q6 hrs **Maximum: 1 gram/dose Ampicillin - IV Neonates: 100 mg/kg/dose (high dose to cover for Group B streptococcal infections) 37-44 weeks: 0-7 days q12 hrs   > 7 days q8 hrs Infants (≥ 45 weeks) and children: General infection: 50 mg/kg/dose q6 hrs Severe infection, S. pneumo, or meningitis: 100 mg/kg/dose q6 hrs **Maximum: 3 grams/dose Cefepime (Maxipime) - IV Neonates (> 2 kg and < 45 weeks): 50 mg/kg/dose q8 hrs Infants (≥ 45 weeks) and children: 50 mg/kg/dose q12 hrs Febrile neutropenia or cystic fibrosis: 50 mg/kg/dose q8 hrs **Maximum: 2 grams/dose** Ampicillin/Sulbactam (Unasyn) - IV Neonates 34-44 weeks: 50 mg/kg/dose ampicillin q8 hrs Infants (≥ 45 weeks) and children: 50-100 mg/kg/dose ampicillin q6 hrs **Maximum: 2 grams ampicillin/dose Total Unasyn = 2:1 ratio of ampicillin to sulbactam Cefotaxime (Claforan) - IV Neonates: 50 mg/kg/dose 37-44 weeks: 0-7 days q12 hrs   > 7 days q8 hrs Infants (≥ 45 weeks) and children: General infection: 50 mg/kg/dose q6 hrs Meningitis: 75 mg/kg/dose q6 hrs **Maximum: 2 grams/dose Fluconazole (Diflucan) - IV or PO ≤ 7 days: LD = 12-25 mg/kg   MD = 6-12 mg/kg q48 hrs > 7 days: LD = 6-12 mg/kg MD = 3-12 mg/kg q24 hrs Dose equivalency (Peds : Adults) 3 mg/kg = 100 mg 6 mg/kg = 200 mg 12 mg/kg = 400 mg **Maximum: 600 mg/day Ceftazidime (Fortaz) - IV Neonates: 50 mg/kg/dose 37-44 weeks: 0-7 days q12 hrs   > 7 days q8 hrs Infants (≥ 45 weeks) and children: 50 mg/kg/dose q8 hrs **Maximum: 2 grams/dose Jordan Anderson, Pharm.D., BCPS & Erin Lammers, Pharm.D., BCPS 2013

WCH / Pediatrics Ertapenem (Invanz) - IV 3 months-12 years: 15 mg/kg/dose q12 hrs > 12 years: 1 gram q24 hrs **Maximum: 1 gram/day WCH / Pediatrics Pharmacy Department Pediatric Dosing Recommendations University of Missouri Health Care Metronidazole (Flagyl) - IV or PO Neonates: LD = 15 mg/kg, MD = 7.5 mg/kg/dose 37-44 weeks: 0-7 days q24 hrs   > 7 days q12 hrs Infants (≥ 45 weeks) and children: 7.5 mg/kg/dose q6 hrs **Maximum: 500 mg/dose Ceftriaxone (Rocephin) - IV **Not recommended in neonates Infants (≥ 45 weeks) and children: Non-CNS infections: 75 mg/kg/dose q24 hrs CNS infections: 50 mg/kg/dose q12 hrs **Maximum: 2 grams/dose Linezolid (Zyvox) - IV or PO ≥ 35 weeks-4 years: 10 mg/kg/dose q8 hrs ≥ 5 years: 10 mg/kg/dose q12 hrs (mild to moderate) or q8 hrs (severe) **Maximum: 600 mg/dose Cefuroxime (Ceftin) - IV Neonates ≤ 7 days: 50 mg/kg/dose q12 hrs Neonates > 7 days and children: 50 mg/kg/dose q8 hrs **Maximum: 2 grams/dose Meropenem (Merrem) – IV Neonates: ≥ 32-44 weeks: < 14 days 20 mg/kg/dose q8 hrs   ≥ 14 days 30 mg/kg/dose q8 hrs Infections with MIC 4-8 mcg/mL (> 30 weeks): 40 mg/kg/dose q8 hrs ≥ 45 weeks-3 months: Non-CNS infection or MIC < 4 mcg/mL: 30 mg/kg/dose q8 hrs Meningitis: 40 mg/kg/dose q8 hrs ≥ 3 months: Non-CNS infection: 20 mg/kg/dose q8 hrs Meningitis or cystic fibrosis: 40 mg/kg/dose q8 hrs **Maximum: 2 grams/dose Clindamycin (Cleocin) - IV or PO Neonates: 7.5 mg/kg/dose 37-44 weeks: 0-7 days q12 hrs   > 7 days q8 hrs Infants (≥ 45 weeks) and children: General: 10 mg/kg/dose q8 hrs Severe (MRSA, osteomyelitis): 13 mg/kg/dose q8 hrs **Maximum: 600 mg/dose Piperacillin/Tazobactam (Zosyn) - IV Neonates: 100 mg/kg/dose piperacillin 37-44 weeks: 0-7 days q12 hrs   > 7 days q8 hrs Infants (≥ 45 weeks) and children: 100 mg/kg/dose piperacillin q6 hrs **Maximum: 4 grams piperacillin/dose Total Zosyn = 8:1 ratio of piperacillin to tazobactam Oxacillin - IV Neonates: 50 mg/kg/dose 37-44 weeks: 0-7 days q12 hrs   > 7 days q8 hrs Infants (≥ 45 weeks) and children: 50 mg/kg/dose q6 hours **Maximum: 3 grams/dose