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Antibacterial agents for oral treatment of acute infectious cystitis in children older than two years and adolescents

Antibacterial agents for oral treatment of acute infectious cystitis in children older than two years and adolescents
Antimicrobial Regimen Maximum single dose
Amoxicillin* 13.3 mg/kg 3 times per day 500 mg
Amoxicillin-clavulanate (immediate release formulations)* 22.5 mg amoxicillin/kg twice per day 875 mg amoxicillin
Cefdinir 14 mg/kg once per day 600 mg
Cefixime 4 mg/kg twice per day 200 mg
Cefpodoxime 5 mg/kg twice per day 200 mg
Cefprozil 15 mg/kg twice per day 500 mg
Ceftibuten 9 mg/kg once per day 400 mg
Cefuroxime 15 mg/kg twice per day 500 mg
NitrofurantoinΔ 1.25 to 1.75 mg/kg 4 times per day 100 mg
Trimethoprim-sulfamethoxazole (TMP-SMX)*Δ 4 to 6 mg trimethoprim/kg twice per day 160 mg TMP
Refer to UpToDate topic on treatment of cystitis in children for information regarding choice of antimicrobial therapy.

* Escherichia coli strains may be resistant to amoxicillin, amoxicillin-clavulanate, and trimethoprim-sulfamethoxazole; therapy should be determined based on local susceptibility patterns.

¶ May be indicated if Enterococcus is suspected based on Gram stain, culture, or clinical features (eg, underlying genitourinary abnormality, recurrent urinary tract infection).

Δ May be indicated if Staphylococcus saprophyticus is suspected based on Gram stain, culture, or clinical features (sexually active female adolescent).
Data from:
  1. American Academy of Pediatrics. Tables of antibacterial drug dosages. Red Book: 2021-2024 Report of the Committee on Infectious Diseases, 32nd ed, Kimberlin DW, Barnett ED, Lynfield R, Sawyer MH (Eds), American Academy of Pediatrics, Itasca, IL 2021. p.876.
  2. Wald ER. Cystitis and pyelonephritis. In: Feigin and Cherry's Textbook of Pediatric Infectious Diseases, 8th ed, Cherry JD, Harrison GJ, Kaplan SL, et al (Eds), Elsevier, Philadelphia 2019. p.395.
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