Oral therapy for M. catarrhalis bronchiectasis exacerbations in children

If M. catarrhalis is isolated in the sputum sample of a child with a bronchiectasis exacerbation, useChang, 2023Hill, 2019:

amoxicillin+clavulanate (child: 2 months or older) 22.5+3.2 mg/kg up to 875+125 mg orally, 12-hourly1; see advice on modification and duration of therapy. amoxicillin + clavulanate

For children who have had a hypersensitivity reaction to a penicillin, use:

doxycycline orally, 12-hourly23; see advice on modification and duration of therapy doxycycline

child less than 21 kg: 2.2 mg/kg

child 21 to less than 26 kg: 50 mg

child 26 to 35 kg: 75 mg

child more than 35 kg: 100 mg.

For children who have had a hypersensitivity reaction to a penicillin in whom a suitable formulation of doxycycline is not available, use:

trimethoprim+sulfamethoxazole (child 1 month or older) 4+20 mg/kg up to 160+800 mg orally, 12-hourly; see advice on modification and duration of therapy. trimethoprim + sulfamethoxazole

1 Amoxicillin+clavulanate may be suitable for children aged 1 month to younger than 2 months but a different dosage is required.Return
2 F2162: Doxycycline use is limited because an oral liquid formulation is not marketed in Australia but is available via the Special Access Scheme. For formulation options for children or people with swallowing difficulties, see Don’t Rush to Crush, which is available for purchase from the Advanced Pharmacy Australia website or through a subscription to eMIMSPlus.Return
3 When used short term (eg less than 21 days), doxycycline has not been associated with tooth discolouration, enamel hypoplasia or bone deposition so can be used in children of all ages.Return