| Condition | Major Pathogens | First Choice Therapy | Alternative Therapy | Comments |
|---|---|---|---|---|
|
Influenza See detailed Influenza Guidelines including treatment indications |
Influenza Virus |
Oseltamivir according to body weight: Preterm infants: <38 weeks corrected gestational age: 1 mg/kg/dose enterally bid 38-40 weeks corrected gestational age: 1.5 mg/kg/dose enterally bid >40 weeks corrected gestational age: same as term infant dosing Contact Pediatric ID/ASP for infants with corrected gestational age < 28 weeks Term infants 0-8 months: 3 mg/kg/dose enterally bid Infants 9-11 months: 3.5 mg/kg/dose enterally bid Children >=12 months: <=15kg: 30 mg/dose enterally bid >15-23kg: 45 mg/dose enterally bid >23-40kg: 60 mg/dose enterally bid >40kg: 75 mg/dose enterally bid Duration: 5 days for most patients* *For patients with critical illness or significant immunocompromise, longer courses may be considered based on severity of illness. Please consult ID for assistance in these cases. |
Zanamivir can be used for children age >= 7 years old for treatment or >= 5 years old for prophylaxis - consider in patients unable to tolerate PO but able to use dry powder inhaler: Zanamivir Duration: Treatment, most patients: 5 days* Prophylaxis: 7 days Consult Pediatric ID for use of Peramivir in critically ill patients unable to receive or absorb enteral medications Consult Pediatric ID for use of Baloxivir in patients early in course but with especially high risk for influenza-related complications |
Oseltamivir Dosing for Prophylaxis (most effective if initiated within 48-72 hours of exposure: Age < 3 months: not recommended Infants 3-8 months: 3 mg/kg/dose enterally daily Infants 9-11 months: 3.5 mg/kg/dose enterally daily Children >= 12 months: <=15kg: 30 mg/dose enterally daily >15-23kg: 45 mg/dose enterally daily >23-40kg: 60 mg/dose enterally daily >40kg: 75 mg/dose enterally daily Duration: 7 days |
References:
American Academy of Pediatrics, Committee on Infectious Diseases. Recommendations for prevention and control of influenza, 2020-2021. Pediatrics 2020;146:e2020024588.
Pediatric Empiric Antimicrobial Therapy Guidelines
This is a subsection of the UCSF Benioff Children’s Hospitals Empiric Antimicrobial Therapy Guidelines, developed by the Pediatric Antimicrobial Stewardship Programs at each campus to inform initial selection of empiric antimicrobial therapy for children at the UCSF Benioff Children’s Hospitals and affiliated outpatient sites.
These are guidelines only and not intended to replace clinical judgment. Modification of therapy may be indicated based on patient comorbidities, previous antibiotic therapy or infection history. Doses provided are usual doses but may require modification based on patient age or comorbid conditions. Refer to Pediatric Antimicrobial Dosing Guideline for further guidance on dosing in children, and Neonatal Dosing Guideline for infants < 1 month of age. Consult a pediatric pharmacist for individualized renal or hepatic dose adjustment. Durations provided are usual recommendations for patients who are responding appropriately to therapy. For additional guidance, please contact Pediatric Infectious Diseases (ID) or the Pediatric Antimicrobial Stewardship Program (ASP) at the campus where your patient is receiving care.
For questions or feedback about these guidelines, please email primary content owners, Rachel Wattier, Pediatric ASP Medical Director at BCH SF and Prachi Singh, Pediatric ASP Medical Director at BCH OAK.
The content of these guidelines was updated in July 2021. See Summary and Rationale for Changes (password login to Box needed) for detailed explanations of the content changes.