Intravenous therapy for M. catarrhalis bronchiectasis exacerbations in children

For children with a bronchiectasis exacerbation who require intravenous therapy, if M. catarrhalis is isolated in the sputum sample, use:

1ceftriaxone (child 1 month or older) 50 mg/kg up to 2 g intravenously, daily; see advice on modification and duration of therapy ceftriaxone

1cefotaxime 50 mg/kg up to 2 g intravenously, 8-hourly; see advice on modification and duration of therapy cefotaxime

1amoxicillin+clavulanate intravenously; see advice on modification and duration of therapy amoxicillin + clavulanate

1+0.2 g formulation

child younger than 3 months and less than 4 kg: 25+5 mg/kg 12-hourly

child younger than 3 months and 4 kg or more: 25+5 mg/kg 8-hourly

child 3 months or older and less than 40 kg: 25+5 mg/kg up to 1+0.2 g 8-hourly

child 40 kg or more: 1+0.2 g 6-hourly

2+0.2 g formulation

child 40 kg or more: 2+0.2 g 8-hourly.

For children who have had a nonsevere (immediate or delayed) or a severe immediate¹ hypersensitivity reaction to a penicillin, use ceftriaxone or cefotaxime at the dosages above.

For children who have had a severe delayed² hypersensitivity reaction to a penicillin, use:

moxifloxacin 10 mg/kg up to 400 mg intravenously, daily³; see advice on modification and duration of therapy. moxifloxacin

¹ Severe immediate hypersensitivity reactions include anaphylaxis, compromised airway, airway angioedema, hypotension and collapse.Return

² Severe delayed hypersensitivity reactions include cutaneous adverse drug reactions (eg drug rash with eosinophilia and systemic symptoms [DRESS], Stevens–Johnson syndrome/toxic epidermal necrolysis [SJS/TEN], severe blistering or desquamative rash), and significant internal organ involvement (eg acute interstitial nephritis).Return

³ Moxifloxacin is not licensed for use in children on the basis of animal studies that showed an adverse effect on cartilage development with quinolone use; however, clinical trial data suggest that adverse musculoskeletal events are usually mild and short term, similar to those observed in adults. Moxifloxacin can be used in children when it is the drug of choice.Return