N/A
If symptoms worsen significantly or signs of pneumonia develop (e.g., increased heart and respiratory rate), the patient should be reassessed for community-acquired pneumonia. [cite: 1851]
N/A
N/A
If a child develops signs of pneumonia, such as fast breathing or chest indrawing, they should be reassessed immediately for community-acquired pneumonia. [cite: 1868]
N/A
5 days [cite: 1952]
Consider antibiotics if there are severe symptoms (e.g., systemically very unwell, persistent ear pain despite analgesics, fever ≥39.0°C). If complications like mastoiditis are suspected, specialist referral is required. [cite: 1948]
N/A, as first-line therapy is already narrow-spectrum.
5 days [cite: 1991]
Consider antibiotics for severe symptoms, immunosuppression, or bilateral acute otitis media in children < 2 years. If oral therapy fails or the child deteriorates, refer for hospital admission. [cite: 1930, 1988, 1990]
N/A
5 days (Low risk of Rheumatic Fever) or 10 days (High risk of RF). [cite: 2116]
The only clear indication for antibiotic treatment is to reduce the probability of developing rheumatic fever in endemic settings (e.g., Centor score 3-4). Suppurative complications like a peritonsillar abscess require surgical drainage and IV antibiotics. [cite: 2071, 2105]
N/A, as first-line therapy is narrow-spectrum.
5 days (Low risk of Rheumatic Fever) or 10 days (High risk of RF). [cite: 2179]
Focus on preventing Rheumatic Fever in endemic areas for children with a high likelihood of Group A Strep infection (Centor score 3-4). [cite: 2148]
N/A
5 days [cite: 2395]
Consider antibiotics for persistent symptoms (≥10 days without improvement), severe onset (fever ≥39.0°C and purulent discharge for 3-4 days), or 'red flag' signs like periorbital swelling or severe headache, which require urgent assessment. [cite: 2273, 2284, 2286]
N/A
5 days [cite: 2328]
Consider antibiotics for persistent symptoms (≥10 days), significant worsening after initial improvement, or severe onset (fever ≥39.0°C). [cite: 2310, 2322]
N/A
3 days (if source control achieved) or 5 days (if not). [cite: 2471]
Antibiotics are for severe, spreading infections with systemic signs (facial swelling, fever, trismus). If infection spreads to deep neck spaces (e.g., Ludwig's angina), it is a medical emergency requiring hospitalization and IV antibiotics. [cite: 2403, 2470]
Once surgical/dental source control is achieved, antibiotics can often be stopped or a short course completed.
3 days (if source control achieved) or 5 days (if not). [cite: 2528]
Consider antibiotics only for severe, spreading infections with systemic signs, which requires urgent dental and medical assessment. [cite: 2526]
Discontinue antibiotics after definitive dental treatment and resolution of systemic signs.
5 days [cite: 2610]
If bacterial infection is suspected (unilateral, fluctuance, skin drainage), empiric treatment is indicated. Consider HIV, tuberculosis, or malignancy in the differential diagnosis and perform appropriate testing (biopsy, specific cultures) if suspected. [cite: 2602, 2608, 2609]
If an abscess is drained and the pathogen is identified, treatment can be tailored to the narrowest effective agent.
5 days [cite: 2610]
If symptoms are consistent with a bacterial infection (fever, painful, tender, inflamed node), empiric treatment against S. aureus and S. pyogenes is indicated. [cite: 2606, 2605]
N/A
5 days. [cite: 2667]
If the patient deteriorates, CURB-65 score is ≥2, or they are unable to take oral therapy, admit to the hospital for management of severe CAP with IV antibiotics. [cite: 2664, 2665]
If started on broader-spectrum antibiotics, de-escalate to Amoxicillin once pathogen sensitivities are known or if clinically improving. Switch from IV to oral therapy as soon as the patient is stable.
3 days in areas of low HIV prevalence and no chest indrawing; 5 days if the child has chest indrawing or lives in a region of higher HIV prevalence. [cite: 2668]
If a child shows general danger signs (unable to feed, convulsions, lethargy) or fails to respond to oral amoxicillin, refer for hospital admission and IV antibiotics (e.g., Ampicillin + Gentamicin). [cite: 2659]
Switch from IV to oral amoxicillin as soon as the child is clinically stable and can tolerate oral medication to complete the course.
5 days [cite: 2675]
Consider antibiotics for severe exacerbations, particularly those with increased sputum purulence and volume, along with increased dyspnea. Hospitalization is required for severe cases where supplemental oxygen and systemic steroids are mainstays of treatment. [cite: 2674, 2670]
N/A for typical outpatient management.
N/A
N/A
N/A
3 days for Ciprofloxacin; 4 days for Azithromycin. [cite: 2679]
Antibiotics should ONLY be used for patients with significant acute bloody diarrhoea (dysentery) or in severely immunocompromised patients. If symptoms do not resolve in 24-48 hours, consider parasitic causes. [cite: 2676, 2679]
N/A
3 days for Ciprofloxacin; 4 days for Azithromycin. [cite: 2681]
Antibiotics should ONLY be considered for significant bloody diarrhoea (dysentery) or in severely immunocompromised/malnourished children. [cite: 2681]
N/A
Mild Cases: 7 days. Severe Cases: 10 days. [cite: 2693]
Patients with severe illness (confirmed/suspected intestinal perforation, peritonitis, sepsis) require hospitalization and IV antibiotics (Ceftriaxone). The choice of empiric treatment depends on local fluoroquinolone resistance patterns. [cite: 2693]
Switch from IV to an appropriate oral antibiotic once the patient is clinically improved, afebrile, and able to tolerate oral treatment, guided by susceptibility results if available.
Mild Cases: 7 days. Severe Cases: 10 days. [cite: 2694]
As for adults, severe cases require hospitalization and IV antibiotics based on local resistance patterns. [cite: 2694]
Switch from IV to oral therapy once clinically stable.
5 days. Longer duration may be required if no clinical improvement or underlying medical condition is present. [cite: 2702]
Intravenous antibiotics may be required if the infection is rapidly spreading or not responding to oral antibiotics. Consider need for surgical drainage if an abscess is suspected. [cite: 2702]
N/A for standard oral therapy. If IV is started, switch to oral once clinically stable.
5 days. [cite: 2704]
As for adults. Admit for IV therapy if systemic signs of toxicity or rapid progression. [cite: 2704]
N/A for standard oral therapy.
5 days for treatment. 3 days for prophylaxis in select high-risk cases. [cite: 2738]
Prophylactic antibiotics can be considered for high-risk wounds (e.g., on face or hands, near joints) or in severely immunocompromised patients. IV therapy is needed for severe, rapidly spreading infections. [cite: 2728, 2737]
For bite wounds, amoxicillin+clavulanic acid is preferred due to anaerobic coverage. Cefalexin/Cloxacillin can be used for non-bite wounds. [cite: 2728]
5 days for treatment. 3 days for prophylaxis in select high-risk cases. [cite: 2738]
As for adults. Always evaluate for tetanus and rabies risk. [cite: 2730]
Amoxicillin+clavulanic acid is the preferred option for bite wounds due to anaerobic coverage. [cite: 2730]
Doxycycline: 7 days. Azithromycin: single dose. [cite: 2749] For Lymphogranuloma Venereum (LGV): Doxycycline 100 mg q12h for 21 days. [cite: 2749]
Recent data suggest Doxycycline is more effective and could be prioritized if adherence is not a concern (except in pregnancy). For anorectal infection, Doxycycline is the recommended treatment. [cite: 2749]
N/A
N/A
N/A
N/A
Single dose [cite: 2753]
Dual therapy is preferred if local resistance data is unavailable. If treatment fails (symptoms persist after 5 days), a resistant infection should be suspected. Retreatment options include higher dose ceftriaxone (500mg) or gentamicin, both combined with Azithromycin 2g. [cite: 2753]
Single therapy (e.g., Ceftriaxone 250mg IM) can be used ONLY if local resistance data confirm susceptibility. [cite: 2753]
N/A
N/A
N/A
Varies by stage: Single dose to 3 weeks. [cite: 2767]
Neurosyphilis requires IV Benzylpenicillin 2-4 million IU every 4 hours for 14 days and must be managed in a hospital setting. [cite: 2767]
N/A
10-15 days [cite: 2778]
N/A
N/A
Single dose or 7 days. [cite: 2782]
The 7-day course has evidence for better cure rates and should be considered if treatment adherence is not an issue. [cite: 2782]
N/A
N/A
N/A
N/A
5 days for Nitrofurantoin; 3-5 days for others. 7 days for men. [cite: 2791]
If symptoms of pyelonephritis develop (fever, flank pain, vomiting), the condition must be escalated to Upper UTI management, which often requires IV antibiotics. [cite: 2790]
Nitrofurantoin is the preferred treatment option for acute lower UTI and is active against most ESBL-producing isolates. [cite: 2791]
3-5 days. [cite: 2793]
If a child develops fever or signs of systemic illness, they should be admitted for management of Upper UTI with IV antibiotics. [cite: 2793]
If started on IV therapy, switch to an appropriate oral agent based on culture results as soon as clinically stable.
Typically 7-10 days. Duration depends on the source of infection and clinical response.
For septic shock or high risk of resistant pathogens (e.g., ESBL), consider Meropenem. For suspected MRSA, add Vancomycin. For suspected MDR Pseudomonas, consider adding Amikacin or a Reserve group agent. Empiric therapy should be tailored to the most likely source of infection (e.g., respiratory, intra-abdominal, urinary tract).
Crucial. Re-evaluate at 48-72 hours. Once culture and sensitivity results are available, de-escalate to the narrowest-spectrum effective antibiotic. Switch from IV to oral therapy when the patient is hemodynamically stable and able to take oral medication.
7-14 days depending on source and clinical response.
If no clinical response after 48-72 hours, or in settings with high rates of resistance, switch to a second-choice agent like Ceftriaxone. For hospital-acquired sepsis, consider broader coverage (e.g., Piperacillin+tazobactam or Meropenem).
Narrow therapy based on culture results. Switch from IV to oral therapy once the child is stable.
Varies by pathogen: 5-7 days for Meningococcal, 10-14 days for Pneumococcal, 21 days for Listeria.
If Listeria monocytogenes is suspected (e.g., age >50, immunocompromised), ADD Ampicillin to the regimen. If penicillin-resistant pneumococcus is prevalent, ADD Vancomycin. Dexamethasone is recommended in high-income settings with the first dose.
Once pathogen and susceptibilities are confirmed, switch to the most targeted therapy (e.g., Benzylpenicillin for susceptible pneumococcus or meningococcus). IV therapy is generally required for the full course.
Varies by pathogen; for unknown pathogen, 10 days in older children and 3 weeks in neonates.
For neonatal meningitis, first choice is Ampicillin + Gentamicin or Cefotaxime + Gentamicin. For hospital-acquired or post-neurosurgery meningitis, broaden coverage to include anti-pseudomonal and anti-staphylococcal agents (e.g., Meropenem + Vancomycin).
Tailor therapy to culture results. Steroids are not recommended in neonatal meningitis.
5 days. Consider longer treatment if the patient is not clinically stable by day 5.
For patients with a CURB-65 score ≥ 2, consider adding a macrolide (e.g., Clarithromycin 500mg q12h IV/oral) to cover atypical pathogens.
Simplify empiric treatment to a narrower spectrum antibiotic based on culture results or rapid clinical improvement. Switch to oral therapy when the patient is stable and can tolerate it.
5 days.
If there is no clinical response to first-line treatment after 48-72 hours, switch to a second-choice agent like Ceftriaxone. If the child is HIV positive and under 1 year, add Sulfamethoxazole+trimethoprim for potential Pneumocystis jirovecii pneumonia.
Switch from IV to oral amoxicillin as soon as the child is clinically stable.
7 days.
For patients at high risk for MDR pathogens (prolonged stay, prior antibiotics), Piperacillin+tazobactam is preferred for its Pseudomonas coverage. If risk of MDR Pseudomonas or ESBL-producers is high, consider Meropenem. If MRSA is suspected, add Vancomycin.
De-escalate based on culture results. For example, if a susceptible Enterobacterales is found, switch to Ceftriaxone. Switch from IV to oral therapy once the patient is clinically stable.
7 days.
In settings with a high prevalence of carbapenem-resistant organisms, consider Meropenem as initial therapy. Add Vancomycin for suspected MRSA.
Tailor therapy to culture results. An IV-to-oral switch is recommended when clinically appropriate.
For uncomplicated cholecystitis, stop after surgery. For complicated cases or cholangitis, 5 days after source control.
For severe, hospital-acquired, or high-risk cases (e.g., recent ERCP), use Piperacillin+tazobactam. If ESBL-producing organisms are suspected, consider Meropenem.
Switch to oral antibiotics (e.g., Amoxicillin-clavulanate or Ciprofloxacin+Metronidazole) once the patient is stable. Narrow based on culture results if available.
5 days after source control is achieved.
For severe or complicated cases, Piperacillin+tazobactam or Meropenem provide broader coverage against resistant Gram-negative organisms.
Tailor therapy to culture results. Switch from IV to oral once clinically improving.
4 days after source control is achieved or if treated with antibiotics alone.
Treat with antibiotics for complicated cases (perforation, abscess), or in immunocompromised patients. Severe cases (sepsis, peritonitis) require IV antibiotics (e.g., Piperacillin+tazobactam or Meropenem) and surgical source control.
Start with oral antibiotics for mild cases requiring treatment. Switch from IV to oral once clinically stable. Simplify therapy based on cultures if taken.
N/A
N/A
N/A
10 days
In severe cases, oral Vancomycin is preferred over Metronidazole. The Vancomycin dose can be increased to 500 mg q6h and can be given in combination with IV Metronidazole for very severe/complicated disease.
N/A. Treatment is targeted.
10 days
As for adults, oral Vancomycin is preferred for severe cases.
N/A
7 days
Severe cases require hospitalization and IV therapy. In settings with high ESBL prevalence, consider adding an aminoglycoside (Amikacin/Gentamicin) to a cephalosporin. If no improvement, investigate for complications like an abscess.
Switch from IV to oral therapy once the patient is clinically improving and can tolerate it. Therapy should be tailored to urine culture results.
7 days
As for adults. Severe cases require IV therapy. Consider adding an aminoglycoside in high-resistance settings or for very ill children.
Switch to an appropriate oral agent based on culture results as soon as clinically stable.
4 to 6 weeks.
Empiric treatment should target S. aureus. If risk factors for MRSA are present, consider adding Vancomycin. If Gram-negative infection is suspected (e.g., post-trauma), use a broader agent like Ceftriaxone. Surgical debridement is key for chronic osteomyelitis or abscess.
Targeted therapy based on bone biopsy culture is always preferred. Switch from IV to oral therapy (e.g., Clindamycin) when the patient is clinically stable and an appropriate oral agent is available based on susceptibility.
Around 3 weeks for uncomplicated infections.
Empiric treatment is common. If invasive Salmonella is suspected (e.g., sickle cell disease), use Ceftriaxone. If MRSA is prevalent, consider Clindamycin or Vancomycin.
An early switch from IV to oral therapy is common in children once clinically improving, guided by inflammatory markers like CRP.
Usually 2-3 weeks, guided by clinical response and the need for further debridement.
Add Vancomycin if MRSA is suspected. For extremely ill patients or known resistant pathogens, a carbapenem (e.g., Meropenem) can be used instead of Piperacillin-tazobactam. Initial coverage must be broad.
Crucial after culture results are available. If only Group A Strep is isolated, de-escalate to Penicillin + Clindamycin. Stop clindamycin after 2-3 days as its primary role is anti-toxin.
2-3 weeks, guided by clinical and surgical course.
Add Vancomycin for suspected MRSA, especially if the child has a history of skin infections or recent hospitalization.
Narrow antibiotic coverage once culture results are available. De-escalate to Penicillin + Clindamycin for confirmed Group A Strep infection.
Low-risk: 7 days. High-risk: Until fever resolves for >48h and infection signs are gone.
For high-risk patients, consider adding Amikacin for suspected resistant Gram-negatives or Vancomycin for suspected MRSA/line infection. If fever persists after 48-72h, reassess and consider fungal/viral causes.
For high-risk patients, once clinically stable and afebrile, can switch to oral therapy (e.g., Amox-clav + Cipro) to complete the course.
As for adults.
As for adults, consider adding Amikacin or Vancomycin based on clinical suspicion and local epidemiology.
Switch to oral therapy when clinically appropriate.
Single dose given ≤120 minutes before incision. Prophylaxis should NOT be continued after surgery.
For procedures involving the bowel or contaminated wounds, broader coverage including anaerobes is needed (e.g., Cefazolin + Metronidazole or Amoxicillin+clavulanic acid). For patients with known MRSA colonization, consider adding Vancomycin.
N/A
Single dose given ≤120 minutes before incision.
As for adults.
N/A