1. 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 days
≥ 12 years: mg/kg/dose q8 hrs x 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 weeks: 50 mg/kg/dose ampicillin q8 hrs
Infants (≥ 45 weeks) and children: 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 = 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

2. 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:
≥ 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