IDSA - Antimicrobial Regimens for Acute Bacterial Rhinosinusitis in Children

Initial empirical therapy

 • Amoxicillin-clavulanate (45 mg/kg/day PO bid)

Beta-lactam allergy Type I hypersensitivity

 • Levofloxacin (10–20 mg/kg/day PO every 12–24 h)

Beta-lactam allergy Non–type I hypersensitivity

 • Clindamycina (30–40 mg/kg/day PO tid) plus cefixime (8 mg/kg/day PO bid) or cefpodoxime (10 mg/kg/day PO bid)

Risk for antibiotic resistance or failed initial therapy

 • Amoxicillin-clavulanate (90 mg/kg/day PO bid)

 • Clindamycina (30–40 mg/kg/day PO tid) plus cefixime (8 mg/kg/day PO bid) or cefpodoxime (10 mg/kg/day PO bid)

 • Levofloxacin (10–20 mg/kg/day PO every 12–24 h)

Severe infection requiring hospitalization

 • Ampicillin/sulbactam (200–400 mg/kg/day IV every 6 h)

 • Ceftriaxone (50 mg/kg/day IV every 12 h)

 • Cefotaxime (100–200 mg/kg/day IV every 6 h)

 • Levofloxacin (10–20 mg/kg/day IV every 12–24 h)



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