Newborn

51 (42)

18.1 (9–30)

6 mo

36 (31)

11.9 (6–17.5)

6–24 mo

36 (33)

10.6 (6–17)

2–6 y

37 (34)

8.5 (5–15.5)

>6 y

40 (35)

8.1 (4.5–13.5)

Sodium

135–145 mg/dL

Potassium

3.5–5.0 mg/dL

Phosphorus

8–10.5 mg/dL

Alkaline phosphatase

• 
  

  Infant

150–400 U/L

• 
  

  2–10 y

100–300 U/L

• 
  

  11–18 y (male)

50–375 U/L

• 
  

  11–18 y (female)

30–300 U/L

• 
  

  Erythrocyte sedimentation rate

1–5 mm/h

Creatinine

• 
  

  Infant

0.2–0.4 mg/dL

• 
  

  Child

0.3–0.7 mg/dL

• 
  

  Adult

0.5–1.0 mg/dL

Glucose

• 
  

  1 wk to 16 y

60–105 mg/dL

• 
  

  >16 y

70–115 mg/dL

Albumin

• 
  

  3–4 mo

2.8–5.0 mg/dL

• 
  

  1 y

3.5–5.0 mg/dL

• 
  

  2 y to adult

3.3–5.8 mg/dL

ALT (SGPT)

• 
  

  <1 y

<54 U/L

• 
  

  >1 y

1–30 U/L

AST (SGOT)

• 
  

  <1 y

25–75 U/L

• 
  

  >1 y

0–40 U/L

Amikacin

15–22 mg/kg/d

q8h

i.v., i.m.

Inj. 250 mg/mL

Peak 20–40 µg/mL, trough 5–10 µg/mL

Amoxicillin

Child: 20–50 mg/kg/d

q8h

p.o.

Drops: 50 mg/mL; suspension: 125, 250 mg/mL

Less Gl irritation than ampicillin

Adult: 250–500 mg/dose

q8h

p.o.

Caps: 250, 500 mg; chewable: 125, 250

Amoxicillin and clavulanic acid (Augmentin)

Child: 20–40 mg/kg/d (approx.)

q8h

p.o.

Suspension: 125 and 250 mg/mL; tabs: 250–500 mg

Used with influenza, Staphylococcus aureus, β lactamase producers

Ampicillin

100–400 mg/kg/d

q6h

p.o./i.m./i.v.

Drops: 100 mg/mL; suspension: 125, 250, 500 mg/ml

Maximum oral dose 4 g daily; may cause nephritis

Azithromycin

5–12 mg/kg/dose

q.d.

p.o., i.v.

Tablets: 250–500 mg; solution 500 mg

Aztreonam

30 mg/kg/dose

q6–8h

i.m., i.v.

Solution: 20–40 mg/mL

Carbenicillin

400–600 mg/kg/d

q6h

p.o./i.m., i.v. (cut dose to 1/2)

Cefaclor (Ceclor)

40 mg/kg/d child

q8h

p.o.

Use with caution in renal impaired or pen allergy

Cefadroxil (Duricef, Ultracef)

Child: 30 mg/kg/d

q12h

p.o.

Adult: 500–1,000 mg/d

Cefamandole

Child: 50–150 mg/kg/d

q4–6h

i.m., i.v.

Adult: 4–12 g/d

Cefoperazone (Cefobid)

Child: 100–200 mg/kg/d

q12h

i.m., i.v.

Adult: 2–4 g/d

Cefazolin (Ancef, Kefzol)

Child: 50–100 mg/kg/d

q6–8h

i.m., i.v.

Use with caution in renal failure or pen allergy

Cefdinir

Child: 14 mg/kg/d

q12h or q.d.

p.o.

Capsule: 300 mg

Adult: 300 mg

q12h

Cefepime (Maxipime)

50 mg/kg/dose

q8–12h

i.m., i.v.

Solution: 20 mg/mL; injection 1–2 g

Cefotaxime (Claforan)

Child: 100–200 mg/kg/d

q6–8h

i.m., i.v.

Adult: 2–12 g/d

Cefotetan (Cefotan)

Child: 30–50 mg/kg/dose

q12h

i.m., i.v.

Inj: 1–2 g; IV: 1–2 g

Adult: 1–2 g

q12h

Cefoxitin (Mefoxin)

Child: 80–160 mg/kg/d

q4–6h

i.m., i.v.

Adult: 4–12 g/d

Ceftazidime (Fortaz/Ceptaz)

Child: 90–150 mg/kg/d

q8–12h

i.m., i.v.

Adult: 2–6 g/d

Ceftizoxime

Child: 150–200 mg/kg/d

q8h

i.m., i.v.

Adult: 2–12 g/d

Ceftriaxone (Rocephin)

Child: 50–75 mg/kg/d

q12–24h

i.m., i.v.

Adult: 1–4 g/d

Cefuroxime (Zinacef)

Child: 75–150 mg/kg/d

q8h

i.m., i.v.

Adult: 2–4.5 g/d

Cephalexin (Keflex)

Child: 25–50 mg/kg/d

q6h

p.o.

Drops: 100 mg/mL; suspension: 125, 250 mg/5 mL; tabs: 250, 500, 1,000 mg; caps: 250, 500 mg

Adult: 1–4 g/d

Cephalothin (Keflin)

Child: 80–160 mg/kg/d

q4–6h

i.m., i.v.

Adult: 2–12 g/d

Chloramphenicol

50–100 mg/kg/d

q6h

p.o., i.v.

Monitor levels in infants

Ciprofloxacin (Cipro)

500–750 mg

b.i.d.

p.o.

Not recommended in younger than 16 y

200–400 mg

q2h

i.v.

Clindamycin

Child: 20–30 mg/kg/d

q.i.d

p.o.

Caps: 75, 150, 300 mg

May cause pseudomembranous colitis

25–40 mg/kg/d

q8–8h

i.m., i.v.

Suspension: 75 mg/5 mL

Adult: 600–1,800 mg/d

q6–8h

p.o.

600–3,600 mg/d

q6–12h

i.m., i.v.

Cloxacillin (Tegopen)

Child: 50–100 mg/d

q.i.d.

p.o.

Caps: 250, 500 mg; solution: 125 mg/5 mL

Adult: 1–4 g/d

Daptomycin (Cubicin)

Child 1–5 y old: 10 mg/kg/dose

q.d.

i.v.

IV solution: 500 mg

Avoid use in patients <12 mo for musculoskeletal and neuro adverse effects

Child 6–11 y old: 7 mg/kg/dose

Child 12 to adolescent: 4–6 mg/kg/dose

Adult: 4 mg/kg/dose

Dicloxacillin

Child: 50–100 mg/kg/d

q.i.d.

p.o.

Adult: 500–2,500 mg/d

q.i.d.

p.o.

Doxycycline

5 mg/kg/d

q12h

p.o., i.v.

Caps/tabs: 50, 100; suspension: 25 mg/5 mL

Do not use in children <8 y

Ertapenem (Invanz)

Infant and Child: 15 mg/kg/dose

q12h

i.m., i.v.

Solution: 1 g

Administer with cilastatin

Adolescent and adult: 1,000 mg/d

q.d.

Erythromycin

Child: 30–50 mg/kg/d

q6–8h

p.o., i.v.

Multiple GI discomfort; give after meals; caution with liver disease

Adult: 1–4 g/d

q6h

p.o., i.v.

Ethambutol

15–25 mg/kg/d

q.d.

p.o.

Do not use in children <12 y

Gentamicin

Child: 6–7.5 mg/kg/d

q8h

i.v.

Monitor levels: peak 6–10 mg/L; trough 2 mg/L

Adult: 3–5 mg/kg/d

Linezolid (Zyvox)

Children <12 y old: 10 mg/kg/dose

q8h

p.o., i.v.

Tablet: 600 mg; solution, IV: 2 mg/mL; oral suspension: 20 mg/mL

Can cause bone marrow suppression and thrombocytopenia

Children >12 y old and adults: 600 mg/dose

q12h

Meropenem (Merrem)

Child: 20 mg/kg/dose

q8h

i.v.

Solution: 500 mg

Maximum dose 1,000 mg/dose

Adult: 500–2,000 mg/dose

q8h

Methicillin

Child: 100–400 mg/kg/d

q4–6h

i.m., i.v.

Adult: 4–12 g/d

Metronidazole (Flagyl)

Load with 15 mg/kg, then 7.5 mg/kg/dose

q6h

i.v.

i.v., p.o.

Oxacillin

Child: 50–100 mg/kg/d

q6h

p.o.

Adult: 500–1,000 mg/dose

Penicillin G

Child: 100,000–4000,000 unit/kg/d

q4–6h

i.v.

Probenecid may prolong

25–50 mg/kg/d

q6–8h

p.o.

Adult: 2–24 million unit/d

125–500 mg/dose

q4–6h

q6h

i.v.

p.o.

Penicillin G (potassium)

Child: 25–05 mg/kg/24 h

q6h

p.o.

Must be taken 1 h before or 2 h after meals

Adult: 250–500 mg/dose

q6h

p.o.

Piperacillin-tazobactam (Zosyn)

Children >9 mo: 100 mg piperacillin/kg/dose

q8h

i.v.

Solution: 2 g piperacillin with 0.25 g tazobactam

Maximum dose 16 g piperacillin/d

Adult: 3,000 mg piperacillin/dose

q6h

Rifampin

0–20 mg/kg/dose

q12–24h

i.v., p.o.

Colors secretions red

Trimethoprim–Sulfamethoxazole (Bactrim)

Child: 6–12 TMP/kg/d

q12h

p.o., i.v.

Adult: 160–320 mg Trimethoprim

q12h or q.d.

p.o.

Adult: 8–20 mg TMP/kg/d

q6–12h

i.v.

Tetracycline HCL

Older child: 25–50 mg/kg/d

q6h

p.o.

Do not use in <8 y

Adult: 1–2 g/d

Ticarcillin

200–300 mg/kg/d

q4–6h

i.m., i.v.

Contains Na

Tobramycin

Child: 6–7.5 mg/kg/d

q8h

i.v.

Check levels; peak 6–10 mg/L, trough <2 mg/L

Adult: 3–5 mg/kg/d

Vancomycin

Child: 10 mg/kg/dose

q8h

i.v.

Benadryl can reverse red man syndrome

Adult: 2 g/d

q8–12h

Acetaminophen (Tylenol)

65 mg/kg/24 h

q4–6h

p.o./p.r.

Hepatotoxicity;

exacerbates g6PD

Acetaminophen + oxycodone (Percocet)

0.1–0.2 mg oxycodone /kg/dose

q4–6h

p.o.

Acetaminophen + hydrocodone (Vicodin)

<50 kg: 0.1–0.2 mg hydrocodone/kg/dose

q4–6h

p.o.

> 50 kg: 5–10 mg hydrocodone

q4–6h

p.o.

Albuterol (Proventil, Ventolin)

2–5 y: 3 mg/kg/d

q8h

p.o., inhalant nebulizer

Tachycardia

6–11 y: 2 mg/dose

>12 y: 2–4 mg/dose

Amitriptyline (analgesia)

0.1 mg/kg/dose, may advance as tolerated to 2 mg/kg

q.d.

p.o.

Ascorbic acid (vitamin C)

35–50 mg/kg

q.d.

p.o.

Aspirin

65 mg/kg 24 h; max 3–6 g/24 h

q4–6h

p.o./p.r.

GI upset, bleeding. Do not use for chicken pox or flulike symptoms Therapeutic levels 150–300 mg/L

Baclofen

Initial dose 5 mg

t.i.d.

p.o.

Avoid abrupt withdrawal

Increase 5 mg t.i.d. q3d until maximum of 10–15 mg t.i.d. for child 2–7 y

20 mg t.i.d. for child 7–8 y

20 mg q.i.d. for adult

Beclomethasone

1 to 2 inhalations

q6h

Bisacodyl (Dulcolax)

2–11 y, 5–10 mg

p.r.n.

p.r.

Effect takes 30 min

>11 y, 10 mg

Calcium carbonate (Os-Cal, Tums)

q.i.d.

p.o.

May cause constipation

Celecoxib (Celebrex)

10–25 kg: 50 mg/dose

q12h

p.o.

Risk of thrombosis

>25 kg: 100 mg/dose

q12h

p.o.

Chloral hydrate—sedative/hypnotic

50–100 mg/kg/dose

Cimetidine

Children: 20–40 mg/kg/d

q8–12h

Contraindicated in renal, cardiac disease

Adults: 1.2 g/d

Codeine

1 mg/kg/dose

q4h

p.o./i.m.

Coumadin (Warfarin)

Treatment target INR is 2–3; for low-dose prophylaxis, target INR is 1.5–1.9

p.o.

Dantrolene for malignant hyperthermia crisis

1 mg/kg; repeat until signs and symptoms normalize, up to 10 mg/kg

Diazepam (Valium)

Sedative: 0.1–0.3 mg/kg/d

q2–4h

i.m./p.o.

Anticonvulsant: 0.1–0.3 mg/kg/dose

i.v. bolus

Rate should not exceed 5 mg/min. Maximum dose: infants and toddlers, 5 mg. Older children, 15 mg. May repeat q15 min, ×2

Diphenhydramine (Benadryl)

Child: 5 mg/kg/d

q6h

p.o., i.v.

Adult: 100–200 mg/d

q6h

p.o., i.v.

Dimetapp (decongestant/antihistamine)

1 mo to 2 y: 1.25 mL

q6–8h

p.o.

2–4 y: 3.75 mL

q6–8h

p.o.

4–12 y: 5 mL

q6–8h

p.o.

>12 y: 5–10 mL

q6–8h

p.o.

1 tab

q12h

p.o.

Docusate sodium laxative (Colace)

<3 y: 10–40 mg/24 h

q6–12h

p.o.

3–6 y: 20–60 mg/24 h

q6–12h

p.o.

6–12 y: 40–120 mg/24 h

q6–12h

p.o.

>12 y: 50–200 mg/24 h

q6–12h

p.o.

Docusate and casanthranol (laxative) (Peri-Colace)

5–10 mL

q.h.s.

p.o.

Fentanyl

0.5–3.0 µg/kg/dose

q1h

i.v.

Give over 3 min

Ferrous sulfate

Drops (15 mg Fe/0.6 mL)

q8h

p.o.

Syrup (18 mg Fe/5 mL)

Elixir (44 mg Fe/5 mL)

Tablet (60 mg Fe/tab)

Dose 3 mg Fe/kg/24 h

Folic acid (vitamin)

Dose 1 mg/d

p.o.

Furosemide (Lasix)

Child: 1 mg/kg/dose (may increase by 1 mg/kg/dose)

q6–12h

i.v.

Adult: 20–80 mg/dose

Haloperidol (sedative)

0.01–0.1 mg/kg

q2h

p.o.

Hydromorphone (Dilaudid)

1–4 mg

q4–6h

p.o., i.v., i.m.

Fewer side effects than morphine sulfate

Ibuprofen (Motrin, Advil)

20–40 mg/kg/d (suspension = 100 mg/tsp) (tablets = 200, 400, 600 mg)

q6–8h

p.o.

Ketamine (hypnotic)

4–8 mg/kg

i.m.

May cause laryngospasm, respiratory depression

0.5–2 mg/kg

i.v.

Ketorolac (Toradol)

Child: 1 mg/kg load, 0.5 mg/kg dose

q6h

i.v.

Do not use parenterally >5 d

Adult: 10 mg

q6h

p.o.

Lidocaine—local anesthetic

Up to 1 mg/kg for regional block

Meperidine HCL (Demerol)

Child: 1—1.5 mg/kg/dose

q6h

p.o./i.m./i.v.

Adult: 50–150 mg/dose

q6h

p.o./i.m./i.v.

Methadone (Dolophine)

0.1 mg/kg/dose

q4h for 2–3 doses, then q6–12h as needed

p.o./i.m./i.v.

Methylprednisolone (steroid dose for spinal cord injury)

30 mg/kg bolus, then 5.4 mg/kg/h × 23 h

i.v.

Midazolam (sedative/amnestic; Versed)

0.05–0.15 mg/kg/dose

q4h

i.m., s.c.

1.0 mg/kg/dose

p.r.

Morphine sulfate

0.1–0.3 mg/kg/dose

q4h

i.m., s.c.

0.1 mg/kg/dose

q2h

i.v.

Naloxone (Narcan)

Continuous: 0.025–2 mg/kg/h

Short acting, may need redose

0.01–0.1 mg/kg/dose

Up to maximum 2 mg/dose. Repeat q 3–5 min

Naproxen (Aleve)

10 mg/kg/d (suspension = 125 mg/tsp) (tablets 250 and 375 mg)

q12h

p.o.

Nortriptyline (analgesia)

Titrate up to 0.05–1 mg/kg/dose

q.d.

p.o.

Max dose 3 mg/kg/d or 150 mg/d

Nystatin (antifungal, topical)

Infants: 1 mL

q6h

p.o.

Children: 2–3 mL

q6h

p.o.

Ondansetron (Zofran)

0.15 mg/kg/dose

q4h × 3

i.v.

Oxycodone (OxyContin)

Child: 0.05–0.15 mg/kg/dose

q6h

p.o.

Abuse potential, urinary retention

Adult: 5 mg

Paraldehyde (sedative/hypnotic)

0.3 mL/kg/dose

i.m./p.o./p.r.

Paregoric (analgesic)

0.25–0.5 mL/kg/dose

q6h

p.o.

Prochlorperazine (antiemetic; Compazine)

(>2 y only) 0.4 mg/kg/d

q6–8h

p.o./p.r.

0.13 mg/kg (single dose)

i.m.

Promethazine (Phenergan)

Child: 0.25–0.5 mg/kg/dose

q4h

p.o./i.m./i.v.

Ranitidine HCL (Zantac)

Child: 2–4 mg/kg/d

q12h

p.o.

1–2 mg/kg/d

q12h

i.v.

Tramadol (Ultram)

Child: 1–2 mg/kg/dose up to 100 mg

q4–6h

p.o.

Potential respiratory complications

Adults: 50–100 mg/dose

q4–6h

Tranexamic acid

100 mg/kg loading dose followed by 10 mg/kg/h until closure

N/A

i.v.

Trimethobenzamide (antiemetic; Tigan)

<13.6 kg: 100 mg

q6–8h

p.o.

13.6–40 kg: 100–200 mg

q12h

p.o.

>40 kg: 300 mg

q12h

p.o.

Valproate (Depakote, antiepileptic)

Initial 10–15 mg/kg/d, increasing by 5–10 mg/kg/d weekly

q8–24h

p.o.