Table 4.6. Treatment Recommendations for Tularemia in Children Before Test Results Are Known

Drug

Dosage

Preferred choices

Streptomycin

15 mg/kg, IM, BID × 10 days (should not exceed 2 gram/day)

Gentamicin

2.5 mg/kg, IM or IV, TID × 10 days (not an FDA-approved use)

Alternative choices

Doxycyclinea

If weight ≥45 kg, 100 mg, IV × 14-21 days

If weight <45 kg, give 2.2 mg/kg, IV, BID × 14-21 days

Chloramphenicola

15 mg/kg, IV, 4 times daily × 14-21 days (not an FDA-approved use)

Ciprofloxacina

15 mg/kg, IV, BID × 10 days (should not exceed 1 gram/day)

Notes: BID = twice a day; TID = three times a day; PO = by mouth; IV = intravenous; IM = intramuscular; FDA = Food and Drug Administration.

a Treatment with doxycycline, chloramphenicol, or ciprofloxacin given IM or IV can be switched to oral administration when clinically indicated.

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