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# Medicines | |
# Antibiotics | |
Antibiotics are medicines that fight infection from bacteria. They | |
do not help against infections from a virus such as chicken pox, | |
rubella, flu, or the common cold. Not all antibiotics will fight all | |
infections from bacteria. | |
Antibiotics that share the same chemical make-up are said to be from | |
the same family. It is important to know about the families of | |
antibiotics for two reasons: | |
* Antibiotics from the same family can often treat the same | |
problems. This means you can use a different medicine from the | |
same family. | |
* If you are allergic to an antibiotic of one family, you will also | |
be allergic to the other members of the same family of antibiotics. | |
This means you will have to take not just a different medicine, | |
but a medicine from a different family instead. | |
Antibiotics must be given for their full course. Stopping before you | |
have finished all the days of treatment, even if you feel better, can | |
make the infection return in a form that is even harder to stop. | |
# The penicillins | |
Medicines in the penicillin family are some of the most useful | |
antibiotics because they fight many infections. | |
Penicillin is measured in milligrams (mg) or units (U). For | |
penicillin G, 250 mg = 400,000 U. | |
For most people, penicillin is one of the safest medicines. Using | |
more than the recommended amount wastes money but is not likely to | |
harm the person. | |
## Resistance to penicillin | |
Certain infections have become resistant to penicillin. This means | |
that in the past penicillin would have been able to cure someone with | |
these infections, but now penicillin does not work. If the infection | |
does not respond to ordinary penicillin, try a different form of | |
penicillin or an antibiotic from another family. For example, | |
pneumonia is sometimes resistant to penicillin. Try cotrimoxazole or | |
erythromycin. | |
## Important! | |
For all kinds of penicillin (including ampicillin and amoxicillin): | |
Some people are allergic to penicillin. Mild allergic reactions | |
cause a rash. Often this comes several hours or days after taking | |
penicillin and may last for days. Stop taking the penicillin | |
immediately. Antihistamines help calm the itching. Stomach upset | |
and diarrhea from taking penicillin are not signs of an allergic | |
reaction and, while uncomfortable, are not a reason to stop taking it. | |
Rarely, penicillin can cause a severe allergy called allergic shock. | |
Within a few minutes or hours after taking penicillin, the person | |
becomes flushed, gets a swollen throat and lips, has trouble | |
breathing, feels faint, and goes into a state of shock. This is very | |
dangerous. Epinephrine (adrenalin) must be injected at once. Always | |
have epinephrine ready when you inject penicillin. | |
epinephrine | |
Someone who has once had an allergic reaction to penicillin should | |
not be given any kind of penicillin--ampicillin, amoxicillin, or | |
others--ever again, either by mouth or by injection. This is because | |
the next time the allergic reaction could be worse and might even | |
kill him. People allergic to penicillin can use erythromycin or | |
other antibiotics instead. | |
## Injections | |
Penicillin usually works well when given by mouth. Injected forms of | |
penicillin can be dangerous. They are more likely to cause severe | |
allergic reactions and other problems, and should be used with | |
caution. Use injectable penicillin only for severe or dangerous | |
infections. | |
# Ampicillin and Amoxicillin | |
Ampicillin and amoxicillin are broad-spectrum penicillins, which | |
means they kill many kinds of bacteria. The two are often | |
interchangeable. When you see a recommendation for ampicillin in | |
this book, you will often be able to use amoxicillin in its place, in | |
the correct dose. | |
Ampicillin and amoxicillin are very safe and are especially useful | |
for babies and small children. | |
## Side effects | |
Both these medicines, but especially ampicillin, tend to cause nausea | |
and diarrhea. Avoid giving them to people who already have diarrhea | |
if you can give another antibiotic instead. | |
The other common side effect is rash. But raised, itchy bumps that | |
come and go in a few hours are probably a sign of penicillin allergy. | |
Stop giving the medicine right away and do not give the person a | |
penicillin medicine again. Future allergic reactions may be more | |
severe and even life-threatening. For some problems, erythromycin | |
can be used instead. A flat rash that looks like measles, and | |
usually appears a week after starting the medicine and takes days to | |
go away, is not necessarily an allergy. But it is impossible to know | |
for sure if the rash is from allergy or not, so it is usually better | |
to stop taking the medicine. | |
## Important! | |
More infections are becoming resistant to ampicillin and amoxicillin. | |
Depending on where you live, they may no longer work any against | |
staphylococcus, shigella, or other infections. | |
## How to use | |
Pill, Injection | |
Ampicillin and amoxicillin work well when taken by mouth. Ampicillin | |
can also be given by injection for severe illnesses. | |
As with other antibiotics, always give these medicines for at least | |
the shorter number of days shown here. If the person still has signs | |
of infection, have her continue taking the same amount every day | |
until all signs of infection have been gone for at least 24 hours. | |
If the person has taken the medicine for the maximum number of days | |
and is still sick, stop giving the antibiotic and get medical help. | |
For people with HIV, always give the medicine for the maximum number | |
of days listed. | |
Likewise, the amount of antibiotic to take depends on the age or | |
weight of the person and the severity of the infection. In general, | |
give the smaller amount of the range for a thinner person or for a | |
less severe infection, and the larger amount for a heavier person or | |
a more severe infection. | |
# AMOXICILLIN (ORAL) | |
Give 45 to 50 mg per kg each day, divided into 2 doses a day. If you | |
cannot weigh the person, dose by age: | |
* Under 3 months: give 125 mg, 2 times a day for 7 to 10 days. | |
* 3 months to 3 years: give 250 mg, 2 times a day for 7 to 10 days. | |
* 4 to 7 years: give 375 mg, 2 times a day for 7 to 10 days. | |
* 8 to 12 years: give 500 mg, 2 times a day for 7 to 10 days. | |
* Over 12 years: give 500 to 875 mg, 2 times a day for 7 to 10 days. | |
# AMPICILLIN (ORAL) | |
Give 50 to 100 mg per kg each day, divided into 4 doses a day. If | |
you cannot weigh the person, dose by age: | |
* Under 1 year: give 100 mg, 4 times a day for 7 days. | |
* 1 to 3 years: give 125 mg, 4 times a day for 7 days. | |
* 4 to 7 years: give 250 mg, 4 times a day for 7 days. | |
* 8 to 12 years: give 375 mg, 4 times a day for 7 days. | |
* Over 12 years: give 500 mg, 4 times a day for 7 days. | |
# AMPICILLIN (INJECTION) | |
Ampicillin should be injected only for severe illnesses, or when | |
someone is vomiting or cannot swallow. | |
Inject 100 to 200 mg per kg each day, divided into 4 doses a day. If | |
you cannot weigh the person, dose by age: | |
* Under 1 year: inject 100 mg, 4 times a day for 7 days. | |
* 1 to 5 years: inject 300 mg, 4 times a day for 7 days. | |
* 6 to 12 years: inject 625 mg, 4 times a day for 7 days. | |
* Over 12 years: inject 875 mg, 4 times a day for 7 days. | |
# Amoxicillin with clavulanic acid | |
(Amoxicillin-clavulanate potassium) | |
Amoxicillin with clavulanic acid comes in different strengths of each | |
of the 2 medicines it contains, for example, 500/125 (a 4 to 1 | |
strength because the tablets have 500 mg amoxicillin and 125 mg | |
clavulanic acid) or 875/125 (a 7 to 1 strength). For children, it is | |
best to use the 4 to 1 ratio such as the 500/125 tablet or the liquid | |
medicine where 5 ml contains 125/31.25 or 250/62.5. Often, the dose | |
of amoxicillin with clavulanic acid mentions only the amount of | |
amoxicillin (as we do here). | |
## How to use | |
Pill, Spoon | |
Give by mouth with food or milk. | |
For animal bites To prevent infection and using a 4 to 1 strength | |
such as the 500/125 tablet or a syrup made for children, give 20 mg | |
per kg each day for 3 to 5 days, divided into 3 doses. If you cannot | |
weigh the person, dose by age: | |
* 3 months to 1 year: give 50 mg, 3 times a day for 3 to 5 days. | |
* 1 to 5 years: give 125 mg, 3 times a day for 3 to 5 days. | |
* 6 to 12 years: give 250 mg, 3 times a day for 3 to 5 days. | |
* Over 12 years: 250 mg, 3 times a day OR use the 875/125 tablet, 2 | |
times a day for 3 to 5 days. | |
If the bite is already infected, use the same dose for up to 14 days. | |
# Penicillin by mouth, penicillin V, penicillin VK | |
Penicillin by mouth (rather than by injection) can be used for mild | |
and moderate infections. | |
Even if you started with injected penicillin for a severe infection, | |
you can usually switch to penicillin by mouth once the person starts | |
to improve. If improvement does not begin within 2 or 3 days, | |
consider switching to another antibiotic and get medical advice. | |
## How to use | |
Pill | |
To help the body make better use of the medicine, take penicillin on | |
an empty stomach, at least 1 hour before or 2 hours after meals. | |
Give 25 to 50 mg per kg each day, divided into 4 doses, for 10 days. | |
If you cannot weigh the person, dose by age: | |
* Under 1 year: give 62 mg, 4 times a day for 10 days. | |
* 1 to 5 years: give 125 mg, 4 times a day for 10 days. | |
* 6 to 12 years: give 125 to 250 mg, 4 times a day for 10 days. | |
* Over 12 years: give 250 to 500 mg, 4 times a day for 10 days. | |
For more serious infections, double the doses above. | |
For a wound likely to be infected with tetanus, along with medicines | |
to prevent tetanus, antibiotics are sometimes given. For example, | |
give penicillin G for 2 days, switch to penicillin V in the dose | |
above for 5 to 8 more days. | |
For animal bites, give the dose above for 3 to 5 days. Also give | |
metronidazole OR clindamycin. | |
# Injectable penicillin, penicillin G | |
Injectable penicillin is used for certain severe infections, | |
including infections from wounds. | |
Injectable penicillin comes in different forms. The main difference | |
is how long the medicine lasts in the body and how quickly it works: | |
short-acting, intermediate-acting, or long-acting. | |
## How to use | |
Injection | |
PROCAINE PENICILLIN, PROCAINE BENZYLPENICILLIN (intermediate-acting) | |
Inject only in the muscle (IM), not in the vein (IV). | |
Give 25,000 to 50,000 units (U, or IU) per kg per day. Do not give | |
more than 4,800,000 units. If you cannot weigh the person, dose by | |
age: | |
* 2 months to 3 years: inject 150,000 units, 1 time a day for 10 to | |
15 days. | |
* 4 to 7 years: inject 300,000 units, 1 time a day for 10 to 15 | |
days. | |
* 8 to 12 years: inject 600,000 units, 1 time a day for 10 to 15 | |
days. | |
* Over 12 years: inject 600,000 to 4,800,000 units, 1 time a day | |
for 10 to 15 days. | |
* Do not give to babies under 2 months unless no other penicillin | |
or ampicillin is available. If this is your only choice, inject | |
50,000 units, 1 time a day for 10 to 15 days. | |
For very severe infections in any age, double the above dose. | |
For a wound likely to be infected with tetanus, along with medicines | |
to prevent tetanus, antibiotics are sometimes given. For example, | |
give the above dose for 7 to 10 days. OR, give the above dose for 2 | |
days, then switch to penicillin by mouth (penicillin V). | |
# Cloxacillin | |
Cloxacillin is a form of penicillin, and can sometimes be used for | |
infections that have become resistant to penicillin, such as sores on | |
the skin with pus, and bone infections. If you do not have | |
cloxacillin, dicloxacillin can be used instead. | |
## Side effects | |
Nausea, vomiting, diarrhea, fever, and joint pain. | |
## Important! | |
Do not give if the person is allergic to penicillin. | |
## How to use | |
Pill | |
For most infections: | |
For young children give 25 to 50 mg per kg, divided into 4 doses a | |
day. For adults give 50 to 100 mg per kg, divided into 4 doses a | |
day. If you cannot weigh the person, dose by age: | |
* Under 2 years: give 75 mg, 4 times a day. | |
* 2 to 10 years: give 125 mg, 4 times a day. | |
* Over 10 years: give 250 to 500 mg, 4 times a day. | |
Double these amounts for severe infections. | |
For knife or gunshot wound, give the dose above for 10 to 14 days. | |
If the wound is dirty or in the abdomen, also give metronidazole. | |
For a bone that has broken through the skin (open fracture), give the | |
dose above for 5 to 7 days. If the wound is very dirty, also give | |
metronidazole. | |
# Dicloxacillin | |
Dicloxacillin is a form of penicillin, and can sometimes be used for | |
infections that have become resistant to penicillin. If you do not | |
have dicloxacillin, cloxacillin can be used instead. | |
## Side effects | |
Nausea, stomach pain, loss of appetite. | |
## Important! | |
* Do not give if the person is allergic to penicillin. Do not give | |
to newborns. | |
* Stop taking if you begin to have dark urine, gray colored stools | |
or jaundice (yellow skin and eyes). | |
## How to use | |
Pill | |
Give with a full glass of water. Give 1 hour before eating, or 2 | |
hours after eating. | |
For children under 40 kg, give 12.5 to 25 mg per kg, divided into 4 | |
doses a day. If you cannot weigh the person, dose by age: | |
* Under 1 year: give 20 mg by mouth, 4 times a day. | |
* 1 to 5 years: give 30 mg by mouth, 4 times a day. | |
* 6 to 12 years: give 80 mg by mouth, 4 times a day. | |
* Over 12 years: give 125 to 250 mg by mouth, 4 times a day. | |
For an infected wound, give the dose above for 5 to 7 days. If the | |
wound is very dirty, also give metronidazole. | |
For a burn that is infected, give the dose above for 5 to 7 days. If | |
it is a deep burn, or the person has a fever, give the dose above for | |
10 to 14 days. | |
# Other antibiotics | |
# Erythromycin | |
Erythromycin works against many of the same infections as penicillin | |
and can be used by those who are allergic to penicillins. For many | |
infections, it can also be used in place of tetracycline. It can | |
also be used for diphtheria and pertussis (whooping cough). | |
## Side effects | |
Erythromycin often causes nausea and diarrhea, especially in | |
children. Do not use for more than 2 weeks as it may cause jaundice. | |
## How to use | |
Pill | |
Give 30 to 50 mg per kg each day, divided into 2 to 4 doses a day. | |
If you cannot weigh the person, dose by age: | |
* Newborns up to 1 month old: give 62 mg, 3 times a day for 7 to 10 | |
days. | |
* 1 month to 2 years: give 125 mg, 3 or 4 times a day for 7 to 10 | |
days. | |
* 2 to 8 years: give 250 mg, 3 or 4 times a day for 7 to 10 days. | |
* Over 8 years: give 250 to 500 mg, 4 times a day for 7 to 10 days. | |
For severe infections, double the doses above. | |
# Tetracycline and Doxycycline | |
Tetracycline and doxycycline are broad-spectrum antibiotics and fight | |
many different kinds of bacteria. They work well when given by mouth | |
(and are very painful when injected, so they should not be given that | |
way). There are more infections that are now resistant to these | |
medicines so they are not used as much as they once were, but they | |
are still useful for fighting some infections. | |
Doxycycline and tetracycline can be used interchangeably. But | |
doxycycline is usually a better choice because less is needed each | |
day and it has fewer side effects. | |
## Side effects | |
Heartburn, stomach cramps, diarrhea, and yeast infections are common. | |
## Important! | |
* Pregnant women should not take these medicines, as they can | |
damage or stain the baby's teeth and bones. For the same reason, | |
children under 8 years old should take them only when there is no | |
other effective antibiotic, and for short periods only. You can | |
usually use erythromycin instead. | |
* Some people may develop a skin rash or get easily sunburned after | |
spending time in the sun while taking these medicines, so stay out | |
of the sun or wear a large hat. | |
## How to use | |
Pill | |
# TETRACYCLINE | |
Avoid milk, iron pills, and antacids for 2 hours before or after | |
taking tetracycline. They will make the medicine less effective. | |
Take tetracycline on an empty stomach, at least 1 hour before or 2 | |
hours after meals. | |
For most infections: | |
Give 25 to 50 mg per kg each day, divided into 4 doses a day. If you | |
cannot weigh the person, dose by age: | |
* 8 to 12 years: give 125 mg, 4 times a day for 7 to 10 days. | |
* Over 12 years: give 250 to 500 mg, 4 times a day for 7 to 10 days. | |
# DOXYCYCLINE | |
Doxycycline is taken twice a day (instead of 4 times a day like | |
tetracycline). | |
Avoid iron pills, and antacids for 2 hours before or after taking | |
Doxycycline. They will make the medicine less effective. | |
Take doxycycline with plenty of water. It may be taken with food or | |
milk if it upsets your stomach. | |
For most infections: | |
Give 2 mg per kg in each dose, but do not give more than 100 mg per | |
dose or 200 mg a day. Give twice a day. Or dose by age: | |
* 8 to 12 years: give 50 mg twice a day, for 7 to 10 days. | |
* Over 12 years: give 100 mg twice a day, for 7 to 10 days. | |
For animal bites, give the dose above for 3 to 5 days. Also give | |
metronidazole or clindamycin. | |
# Cotrimoxazole, sulfamethoxazole with trimethoprim, TMP-SMX | |
Cotrimoxazole, a combination of 2 antibiotics is inexpensive and | |
fights a wide range of infections. It is an important medicine for | |
people with HIV and can prevent the many infections that come as a | |
result of HIV infection. See HIV and AIDS (in development). | |
## Important! | |
Avoid giving cotrimoxazole to babies less than 6 weeks old and to | |
women in the last 3 months of pregnancy. Allergy to this medicine is | |
common. Signs of allergic reaction are fever, difficulty breathing, | |
or rash. Stop giving cotrimoxazole if the person develops a rash or | |
if you think there may be an allergy. | |
## How to use | |
Pill | |
Cotrimoxazole comes in different strengths of each of the 2 medicines | |
it contains. So it may say 200/40 (meaning 200 mg sulfamethoxazole | |
and 40 mg trimethoprim) or 400/80 or 800/160. Sometimes a dose is | |
described only in terms of the amount of trimethoprim (the second | |
number). | |
For most infections: | |
* 6 weeks to 5 months: give sulfamethoxazole 100 mg + trimethoprim | |
20 mg, 2 times a day for 5 days. | |
* 6 months to 5 years: give sulfamethoxazole 200 mg + trimethoprim | |
40 mg, 2 times a day 5 days. | |
* 6 to 12 years: give sulfamethoxazole 400 mg + trimethoprim 80 mg, | |
2 times a day 5 days. | |
* Over 12 years: give sulfamethoxazole 800 mg + trimethoprim 160 | |
mg, 2 times a day 5 days. | |
For animal bites, give the amount above for 3 to 5 days. Also give | |
metronidazole or clindamycin. | |
# Clindamycin | |
Clindamycin is another antibiotic used to treat many kinds of | |
bacterial infections. It is especially useful for treating | |
infections that have become resistant to penicillin such as skin | |
infections and abscesses. | |
## Important! | |
If you develop diarrhea that is watery or bloody while taking | |
clindamycin, stop taking it immediately. This can be a sign of | |
dangerous infection caused by the antibiotic. Because the drug can | |
pass through breast milk and harm a baby, avoid giving to a | |
breastfeeding woman. | |
## How to use | |
Pill | |
Give clindamycin by mouth. | |
* Under 3 years: give 37.5 to 75 mg, 3 times a day. | |
* 3 to 7 years: give 75 to 150 mg, 3 times a day. | |
* 8 to 12 years: give 150 to 300 mg, 3 times a day. | |
* Over 12 years: give 150 to 450 mg, 3 times a day. | |
For animal bites, give the dose above for 3 to 5 days. Also give | |
another medicine such as doxycycline, cotrimoxazole OR penicillin V. | |
For an infected wound, give the dose above for 5 to 7 days. | |
For a burn that is infected, give the dose above for 5 to 7 days. If | |
it is a deep burn, or the person also has a fever, give the dose | |
above for 10 to 14 days. | |
For a bone that has broken through the skin (open fracture), give the | |
dose above for 5 to 7 days. If the wound is very dirty, also give | |
ciprofloxacin. | |
For knife or gunshot wound, give the dose above for 10 to 14 days. | |
# Metronidazole | |
Metronidazole is effective at fighting certain bacteria and | |
infections used by itself or in combination with other antibiotics. | |
## Side effects | |
Nausea, cramps, and diarrhea are common. Taking with food may help. | |
Sometimes it causes a metallic taste in the mouth or a headache. | |
## Important! | |
Do not give in the first 3 months of pregnancy because it may cause | |
birth defects. Also avoid giving metronidazole later in pregnancy | |
and while breastfeeding unless it is the only effective medicine and | |
is definitely needed. Do not drink alcohol while taking | |
metronidazole or until 2 days after you finish taking it. Drinking | |
alcohol while taking metronidazole causes severe nausea. Do not use | |
metronidazole if you have liver problems. | |
## How to use | |
Pill | |
Give 30 mg per kg, divided into 4 doses a day. If you cannot weigh | |
the person, dose by age: | |
* Under 1 year: give 37 mg, 4 times a day. | |
* 1 to 5 years: give 75 mg, 4 times a day. | |
* 6 to 12 years: give 150 mg, 4 times a day. | |
* Over 12 years: Give 500 mg, 3 or 4 times a day. Do not give more | |
than 4 g in 24 hours. | |
For an infected wound, give the dose above for 5 to 7 days. Also | |
give dicloxacillin OR cephalexin. | |
For a wound likely to be infected with tetanus, along with medicines | |
to prevent tetanus, antibiotics are sometimes given. For example, | |
give the dose above for 7 to 10 days. | |
For animal bites, give the dose above for 3 to 5 days. Also give | |
another medicine such as doxycycline, cotrimoxazole, OR penicillin V. | |
For a bone that has broken through the skin (open fracture), give the | |
dose above for 5 to 7 days. Also give ceftriaxone, cephalexin OR | |
cloxacillin. | |
# Ciprofloxacin | |
Ciprofloxacin is a broad spectrum antibiotic of the quinolone family. | |
It works against a lot of different infections of the skin, bones, | |
digestive tract, and urinary tract (bladder and kidneys). There are | |
more infections becoming resistant to ciprofloxacin depending on | |
where you live. Only use it only against the infections for which it | |
is specifically recommended in your area. It is not a good | |
antibiotic for children. | |
## Side effects | |
Nausea, diarrhea, vomiting, headache, dizziness, rash, or yeast | |
infections. | |
## Important! | |
* Do not use if you are pregnant or breastfeeding. Do not take | |
with dairy products such as milk or cheese. | |
* Rarely, ciprofloxacin damages the tendons. Except for a few | |
specific situations, it should not be given to children under 16 | |
because their tendons are still developing. If you have pain in | |
your calves when taking this medicine, stop taking it immediately. | |
## How to use | |
Pill | |
For most infections: | |
* Give 250 to 750 mg, twice a day until 24 hours after signs of | |
infection are gone. | |
For sepsis, give the dose above for 2 to 3 days after signs of | |
infection are gone. Also give clindamycin. | |
For a bone that has broken through the skin (open fracture), give the | |
dose above for 5 to 7 days. Also give clindamycin. | |
For a burn that is infected, give the dose above for 5 to 7 days. If | |
it is a deep burn, or the person also has a fever, give the dose | |
above for 10 to 14 days. | |
# Ceftriaxone | |
Ceftriaxone is in the cephalosporin antibiotic family. | |
Cephalosporins are antibiotics that work against many kinds of | |
bacteria. They are often expensive and not widely available. | |
However, they generally have fewer risks and side effects than many | |
other antibiotics and can be useful in treating certain serious | |
diseases. | |
Ceftriaxone is used against serious infections including sepsis and | |
meningitis, and for infections resistant to penicillin. Only use | |
ceftriaxone to treat the specific infections for which it is | |
recommended in your area. | |
Ceftriaxone is especially useful for gonorrhea, including gonorrhea | |
infection of the newborn's eyes but otherwise should not be given to | |
newborns under 1 week old and should be avoided in babies under 1 | |
month old. | |
## Important! | |
Do not give this medicine to someone who is allergic to other | |
cephalosporin antibiotics. | |
Do not give to a baby less than 1 week old, except as treatment for | |
gonorrhea in the eyes. | |
## How to use | |
Injection | |
Ceftriaxone cannot be taken by mouth. When injecting, put the needle | |
deep in the muscle. It can be painful to inject, so mix with 1% | |
lidocaine if you know how. | |
Give 50 to 100 mg per kg each day, divided into 2 doses a day. If | |
you cannot weigh the person, dose by age: | |
* 1 month to 3 months: inject 150 mg, twice a day. | |
* 3 months to 1 year: inject 250 mg, twice a day. | |
* 2 to 4 years: inject 400 mg, twice a day. | |
* 5 to 12 years: inject 625 mg, twice a day. | |
* Over 12 years: inject 1 to 2 grams, once a day. Do not give more | |
than 4 grams in 24 hours. | |
For a bone that has broken rough the skin (open fracture), give the | |
dose above for 5 to 7 days. If the wound is dirty, also give | |
metronidazole. | |
For sepsis, give the dose above until 2 to 3 days after signs of | |
infection are gone. If the wound is dirty, or there is no | |
improvement 24 hours after starting ceftriaxone, also give | |
metronidazole. | |
# Cephalexin | |
Cephalexin is in the cephalosporin antibiotic family. Cephalosporins | |
are antibiotcs that work against many kinds of bacteria. They are | |
often expensive and not widely available. However, they generally | |
have fewer risks and side effects than many other antibiotics and can | |
be useful in treating certain serious diseases. | |
## Side effects | |
Diarrhea that is watery or bloody, fever, sore throat, headache, red | |
skin rash with blistering or peeling, dark colored urine, confusion | |
or weakness. | |
## Important! | |
Do not give this medicine to someone who is allergic to other | |
cephalosporin antibiotics. | |
## How to use | |
Pill | |
Give 50 mg per kg each day, divided into 4 doses a day. Do not give | |
more than 4000 mg in 24 hours. If you cannot weigh the person, dose | |
by age: | |
* Under 6 months: give 100 mg, 4 times a day. | |
* 6 months to 2 years: give 125 mg, 4 times a day. | |
* 3 to 5 years: give 250 mg, 4 times a day. | |
* 6 to 12 years: give 375 mg, 4 times a day. | |
* Over 12 years: give 500 mg, 4 times a day. | |
For an infected wound, give the dose above for 5 to 7 days. If the | |
wound is very dirty, also give metronidazole. | |
For a burn that is infected, give the dose above for 5 to 7 days. If | |
it is a deep burn, or the person has a fever, give the dose above for | |
10 to 14 days. | |
For a bone that has broken through the skin (open fracture), give the | |
dose above for 5 to 7 days. If the wound is very dirty, also give | |
metronidazole. | |
For knife or gunshot wound, give the dose above for 10 to 14 days. | |
If the wound is dirty or in the abdomen, also give metronidazole. | |
# Gentamicin | |
Gentamicin is a very strong antibiotic of the aminoglycoside family. | |
It can only be given by injection or IV (in the vein). This drug can | |
damage the kidneys and the hearing, so it should only be used in | |
emergencies. | |
## Important! | |
Gentamicin must be given in the exactly correct dose. Giving too | |
much can cause kidney damage or permanent deafness. It is best to | |
dose by weight. And do not give gentamicin for more than 10 days. | |
## How to use | |
Injection | |
Inject into the muscle or the vein. | |
For sepsis: | |
* 6 months to 12 years: inject 2.5 mg per kg, 3 times a day. | |
* Over 12 years: inject 1 to 1.7 mg per kg, 3 times a day. | |
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