Pediatric Dosing Quick Reference

Weight-based dosing with concentration-to-volume conversion, copy-paste Rx strings, allergy filter, and a printable caregiver handout per drug.

Adult dosing →·Anaphylaxis emergency card →·Vaccine catch-up →

Verify before prescribing. Doses are for otherwise-healthy children at or above the listed age. Not for neonates <1 month unless noted.

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Drug	Indication	Dose range	Age	Max	Frequency	Duration	Notes
Amoxicillin (standard) Antibiotic Susp 250 mg/5 mL	Strep pharyngitis	50 mg/kg/day divided BID	≥1 mo	1000 mg/day	BID	10 days	First-line for GAS pharyngitis.
Caregiver handout → Safety, pregnancy/lactation & referral Pregnancy: Compatible — first-line for many infections. Lactation: Compatible — small amounts in milk, rarely causes infant rash/diarrhea. Safety notes Complete full 10-day course to prevent rheumatic fever Shake suspension well; refrigerate Contraindications PCN or cephalosporin anaphylaxis Infectious mononucleosis (rash risk) When to call a specialist / ED Recurrent GAS (≥7 episodes/year) → ENT Peritonsillar abscess or trismus → ED PSGN suspicion (dark urine, edema) → PCP Anaphylaxis emergency card →
Amoxicillin (high-dose) Antibiotic Susp 400 mg/5 mL	Acute otitis media, sinusitis	80–90 mg/kg/day divided BID	≥6 mo – ≤12 y (then adult dosing)	3000 mg/day	BID	5–10 days (age-based)	10 d if <2 y or severe; 5–7 d if ≥2 y and mild.
Caregiver handout → Safety, pregnancy/lactation & referral Pregnancy: Compatible. Lactation: Compatible. Safety notes Reassess at 48–72 h if not improving Diarrhea common — hold if severe Contraindications PCN allergy Amoxicillin use in prior 30 days (use amox-clav instead) When to call a specialist / ED Mastoiditis (postauricular swelling/erythema) → ED Recurrent AOM (≥3 in 6 mo or ≥4 in 12 mo) → ENT Persistent effusion >3 mo with hearing concerns → ENT/audiology Anaphylaxis emergency card →
Amoxicillin-clavulanate Antibiotic Susp 600 mg/5 mL (ES)	AOM (tx failure), sinusitis, bite wounds	90 mg/kg/day amox component divided BID	≥3 mo	4000 mg/day	BID	7–10 days	Use ES formulation to limit clavulanate GI upset.
Caregiver handout → Safety, pregnancy/lactation & referral Pregnancy: Compatible. Lactation: Compatible. Safety notes Take with food to reduce GI upset Use ES (600 mg/5 mL) — do not substitute lower-strength suspensions gram-for-gram Contraindications PCN allergy Prior amox-clav cholestatic hepatitis When to call a specialist / ED Deep hand/face bite or tendon involvement → surgery/ED Orbital/periorbital cellulitis → ED Failure after 72 h of amox-clav → PCP/ID Anaphylaxis emergency card →
Cephalexin Antibiotic Susp 250 mg/5 mL	Skin/soft tissue, strep (PCN allergy — non-anaphylactic)	25–50 mg/kg/day divided QID	≥1 mo	4000 mg/day	QID	7–10 days	TID acceptable for mild cases.
Caregiver handout → Safety, pregnancy/lactation & referral Pregnancy: Compatible. Lactation: Compatible. Safety notes Does not cover MRSA — add/switch to TMP-SMX or clinda if suspected QID dosing critical to maintain levels Contraindications Cephalosporin allergy Prior anaphylaxis to any beta-lactam When to call a specialist / ED Abscess >5 cm, on face, or systemic signs → I&D / ED Spreading cellulitis despite 48 h therapy → PCP/ED Anaphylaxis emergency card →
Cefdinir Antibiotic Susp 125 mg/5 mL	AOM, sinusitis (PCN allergy)	14 mg/kg/day divided QD or BID	≥6 mo	600 mg/day	QD or BID	5–10 days	May cause red/orange stool with iron — benign.
Caregiver handout → Safety, pregnancy/lactation & referral Pregnancy: Compatible. Lactation: Compatible. Safety notes Separate from iron/antacids by ≥2 h (chelation) Red stool is chelation, not blood — reassure Contraindications Cephalosporin allergy History of PCN-induced anaphylaxis When to call a specialist / ED Mastoiditis or orbital cellulitis → ED Recurrent AOM → ENT Anaphylaxis emergency card →
Azithromycin Antibiotic Susp 200 mg/5 mL	Pertussis, atypical PNA, PCN-allergic strep	10 mg/kg day 1, then 5 mg/kg days 2–5	≥6 mo	500 mg/dose	QD	5 days	Rising GAS macrolide resistance — verify susceptibility.
Caregiver handout → Safety, pregnancy/lactation & referral Pregnancy: Use with caution — reserve for clear indication. Lactation: Compatible — monitor infant for GI upset. Safety notes QT prolongation risk — screen for cardiac history and concurrent QT-prolonging meds Infants <1 mo: pyloric stenosis risk Contraindications Prior cholestatic jaundice with macrolides Long-QT syndrome When to call a specialist / ED Pertussis in infant <6 mo → hospitalize/pediatrics PNA with hypoxia, retractions, or dehydration → ED Syncope or palpitations on therapy → ED Anaphylaxis emergency card →
TMP-SMX Antibiotic Susp 40/200 mg per 5 mL	UTI, MRSA SSTI	8–12 mg/kg/day TMP divided BID	≥2 mo	320 mg/day	BID	3–10 days	Avoid <2 mo, G6PD deficiency, sulfa allergy.
Caregiver handout → Safety, pregnancy/lactation & referral Pregnancy: AVOID in 1st and 3rd trimesters (neural tube, kernicterus). Lactation: Compatible after 1 month if infant is healthy and full-term; avoid if G6PD or jaundiced. Safety notes Encourage fluids to reduce crystalluria Watch for rash — stop immediately if SJS/TEN features (mucosal involvement, blistering) Contraindications Age <2 mo Sulfa allergy G6PD deficiency Megaloblastic anemia (folate deficiency) Pregnancy 1st/3rd trimester When to call a specialist / ED Any mucosal rash, blistering, or peeling → ED (SJS/TEN) Suspected pyelonephritis (flank pain, high fever) → ED/PCP for IV therapy Recurrent UTI (≥2 in 6 mo) → pediatric urology Anaphylaxis emergency card →
Nitrofurantoin Antibiotic Susp 25 mg/5 mL	Uncomplicated UTI (cystitis)	5–7 mg/kg/day divided QID	≥1 mo	400 mg/day	QID	5–7 days	Cystitis only — no tissue penetration for pyelonephritis.
Caregiver handout → Safety, pregnancy/lactation & referral Pregnancy: Compatible in 2nd trimester; AVOID at term (>38 wk) and 1st trimester if alternatives exist. Lactation: Compatible after 1 month; avoid if infant <1 mo or G6PD deficient. Safety notes Take with food to improve absorption and reduce GI upset Brown urine is expected — reassure Contraindications Age <1 mo CrCl <60 mL/min G6PD deficiency Suspected pyelonephritis or urosepsis When to call a specialist / ED Flank pain, high fever, or vomiting → ED Recurrent UTI → pediatric urology Any GU anomaly (VUR, hydronephrosis) → urology Anaphylaxis emergency card →
Oseltamivir Antiviral Susp 6 mg/mL	Influenza tx (start ≤48 h)	≤15 kg 30 mg BID · 15–23 kg 45 mg BID · 23–40 kg 60 mg BID · >40 kg 75 mg BID	≥2 wk	—	BID	5 days	Prophylaxis is once-daily at the same weight-based dose.
Caregiver handout → Safety, pregnancy/lactation & referral Pregnancy: Compatible — benefits usually outweigh risks in confirmed influenza. Lactation: Compatible. Safety notes Best benefit if started <48 h from symptom onset, but still consider in high-risk or hospitalized N/V common — give with food Monitor for neuropsychiatric events (esp. adolescents) Contraindications Hypersensitivity to oseltamivir Age <2 wk (not established) When to call a specialist / ED Infant <3 mo with flu → pediatrics Hypoxia, dehydration, altered mental status → ED Abrupt behavioral change on therapy → PCP/ED Anaphylaxis emergency card →
Mupirocin 2% ointment Antifungal / Topical Topical	Impetigo (limited lesions)	Apply to lesions	≥2 mo	—	TID	5 days	Switch to oral if extensive or bullous.
Caregiver handout → Safety, pregnancy/lactation & referral Pregnancy: Compatible (topical). Lactation: Compatible (avoid on nipples if directly nursing). Safety notes Wash hands after application; keep lesions covered to limit spread Do not use on mucous membranes or in eyes Contraindications Hypersensitivity to mupirocin or polyethylene glycol Extensive open wounds / burns (systemic PEG absorption) When to call a specialist / ED Bullous impetigo, >2% BSA, or systemic signs → PCP for oral abx Recurrent MRSA colonization → PCP for decolonization protocol Anaphylaxis emergency card →
Nystatin oral suspension Antifungal / Topical Susp 100,000 U/mL	Oral thrush	Infants 2 mL (200,000 U) QID; children 4–6 mL QID	Any	—	QID	7–14 days (× 48 h after clear)	Swab in mouth; do not feed for 30 min after.
Caregiver handout → Safety, pregnancy/lactation & referral Pregnancy: Compatible. Lactation: Compatible. Safety notes Also treat maternal nipples if breastfeeding (topical nystatin) Sterilize/replace pacifiers and bottle nipples Contraindications Hypersensitivity to nystatin When to call a specialist / ED Thrush not clearing after 14 days → PCP (consider immunodeficiency) Thrush in child >12 mo with no risk factors → PCP Difficulty feeding, dehydration → PCP/ED Anaphylaxis emergency card →
Cetirizine Antihistamine Syrup 5 mg/5 mL	Allergic rhinitis, urticaria	6–23 mo 2.5 mg QD · 2–5 y 2.5–5 mg QD · ≥6 y 5–10 mg QD	≥6 mo	10 mg/day	QD	—	Less sedating; preferred over diphenhydramine for chronic use.
Caregiver handout → Safety, pregnancy/lactation & referral Pregnancy: Compatible — preferred second-generation antihistamine. Lactation: Compatible. Safety notes May cause mild sedation in ~10% Reduce dose in renal impairment Contraindications Hypersensitivity to cetirizine or hydroxyzine Age <6 mo When to call a specialist / ED Anaphylaxis (respiratory, hypotension, GI+skin) → epinephrine + ED Chronic urticaria >6 wk → allergy/immunology Anaphylaxis emergency card →
Loratadine Antihistamine Syrup 5 mg/5 mL	Allergic rhinitis, urticaria	2–5 y 5 mg QD · ≥6 y 10 mg QD	≥2 y	10 mg/day	QD	—	Non-sedating.
Caregiver handout → Safety, pregnancy/lactation & referral Pregnancy: Compatible. Lactation: Compatible. Safety notes Reduce to every-other-day in hepatic impairment Contraindications Hypersensitivity to loratadine or desloratadine Age <2 y (OTC labeling) When to call a specialist / ED Anaphylaxis → epinephrine + ED Persistent symptoms despite daily therapy → allergy Anaphylaxis emergency card →
Diphenhydramine Antihistamine Liquid 12.5 mg/5 mL	Acute allergic reaction (short-term)	1.25 mg/kg q6h PRN	≥2 y (avoid OTC use <2 y)	50 mg/dose · 300 mg/day	q6h PRN	—	Sedating; not for chronic rhinitis. Paradoxical excitation possible.
Caregiver handout → Safety, pregnancy/lactation & referral Pregnancy: Compatible — often used for nausea and allergy in pregnancy. Lactation: Use with caution — may reduce milk supply and sedate infant. Prefer loratadine/cetirizine. Safety notes Never combine with other sedating antihistamines or OTC cold meds containing DPH Warn caregivers about paradoxical hyperactivity Contraindications Age <2 y (OTC labeling — respiratory depression risk) Narrow-angle glaucoma Concurrent MAOIs Neonates/premature infants When to call a specialist / ED Any anaphylaxis → epinephrine IM + ED (DPH is adjunct, NOT first-line) Overdose (agitation, seizures, wide-complex tachycardia) → ED immediately Anaphylaxis emergency card →
Acetaminophen Analgesic / Antipyretic Susp 160 mg/5 mL	Fever, pain	15 mg/kg q4–6h	Any	1000 mg/dose · 4000 mg/day	q4–6h PRN	—	Max 75 mg/kg/day (pediatric ceiling) or 4 g/day.
Caregiver handout → Safety, pregnancy/lactation & referral Pregnancy: Compatible — preferred analgesic/antipyretic in pregnancy. Lactation: Compatible. Safety notes Use weight, not age, to dose Warn about combo OTC/Rx products (cough syrups, oxycodone-APAP) to prevent double-dosing Use the dropper/syringe that came with the product Contraindications Severe hepatic impairment or active liver disease Known APAP hypersensitivity When to call a specialist / ED Fever ≥38 °C in infant <3 mo → ED Suspected overdose (>150 mg/kg single or >75 mg/kg/day chronic) → ED / Poison Control 1-800-222-1222 Fever >5 days or ill appearance → PCP/ED Anaphylaxis emergency card →
Ibuprofen Analgesic / Antipyretic Susp 100 mg/5 mL	Fever, pain, inflammation	10 mg/kg q6–8h	≥6 mo	400 mg/dose · 1200 mg/day	q6–8h PRN	—	Give with food. Avoid if dehydrated or with renal disease.
Caregiver handout → Safety, pregnancy/lactation & referral Pregnancy: AVOID after 20 weeks (fetal renal dysfunction, ductus closure). Lactation: Compatible. Safety notes Ensure adequate hydration before dosing Avoid concurrent nephrotoxins (aminoglycosides, ACE-I) Do not use with other NSAIDs Contraindications Age <6 mo Dehydration or hypovolemia CKD or AKI Active GI bleed / peptic ulcer Suspected varicella or dengue (bleeding risk) Aspirin-sensitive asthma When to call a specialist / ED Signs of GI bleed (melena, hematemesis) → ED Suspected overdose → Poison Control / ED Fever with petechial rash → ED Anaphylaxis emergency card →
Dexamethasone Steroid Elixir 0.5 mg/5 mL	Croup (single-dose)	0.6 mg/kg × 1 (PO/IM)	≥3 mo	16 mg/dose	× 1 dose	—	Refer moderate–severe croup (stridor at rest) urgently.
Caregiver handout → Safety, pregnancy/lactation & referral Pregnancy: Short-term use compatible; avoid chronic first-trimester use. Lactation: Compatible for single-dose or short course. Safety notes Single-dose systemic effect is minimal; still document exposure Bitter taste — mix with small amount of juice or use IM if refusing PO Contraindications Active untreated systemic fungal infection Recent live vaccine within 4 wk (relative) Hypersensitivity to dexamethasone When to call a specialist / ED Stridor at rest, retractions, or hypoxia → ED (nebulized epinephrine) Suspected epiglottitis (drooling, tripod, toxic) → ED — do NOT examine throat Recurrent croup or age >6 y → ENT/pulm Anaphylaxis emergency card →
Prednisolone Steroid Susp 15 mg/5 mL	Asthma exacerbation	1–2 mg/kg/day	Any	60 mg/day	QD or divided BID	3–5 days	Refer or send to ED if severe or hypoxic.
Caregiver handout → Safety, pregnancy/lactation & referral Pregnancy: Compatible for short bursts. Lactation: Compatible. Safety notes No taper needed for ≤7-day burst Reassess response at 24–48 h Monitor blood glucose if diabetic Contraindications Active untreated systemic fungal or bacterial infection Live vaccines during high-dose therapy Hypersensitivity When to call a specialist / ED SpO₂ <92%, silent chest, or exhaustion → ED ≥2 ED visits or ≥2 oral steroid bursts in 12 mo → pediatric pulm/allergy Suspected anaphylaxis-triggered exacerbation → epinephrine + ED Anaphylaxis emergency card →
Erythromycin ophthalmic 0.5% Ophthalmic / Otic Ointment	Bacterial conjunctivitis	Ribbon to affected eye(s)	Any	—	QID	5–7 days	Non-stinging; preferred in young children.
Caregiver handout → Safety, pregnancy/lactation & referral Pregnancy: Compatible. Lactation: Compatible. Safety notes Blurs vision briefly after application Do not let tube tip touch eye — contamination risk Contraindications Hypersensitivity to erythromycin Viral or fungal keratitis When to call a specialist / ED Photophobia, vision changes, or eye pain → ophthalmology Contact-lens wearer with red eye → ophthalmology (Pseudomonas risk) Neonate <28 days with conjunctivitis → ED (rule out gonococcal/chlamydial/HSV) Hyperacute purulent discharge → ED Anaphylaxis emergency card →
Ofloxacin 0.3% otic Ophthalmic / Otic Otic solution	Otitis externa; AOM with tubes/perforation	5 drops to affected ear	≥6 mo (≥1 y for OE labeling)	—	BID	7 days	Safe with perforated TM (unlike neomycin).
Caregiver handout → Safety, pregnancy/lactation & referral Pregnancy: Compatible (topical — minimal absorption). Lactation: Compatible. Safety notes Warm bottle in hand before instillation to reduce vertigo Have patient lie with treated ear up for 5 minutes Keep ear canal dry between doses Contraindications Fluoroquinolone hypersensitivity Viral otic infection (HSV/varicella) When to call a specialist / ED Postauricular swelling/erythema (mastoiditis) → ED Facial nerve weakness → ED Malignant otitis externa in immunocompromised → ED/ID No improvement after 7 days → ENT Anaphylaxis emergency card →

Amoxicillin (standard)

Antibiotic

Strep pharyngitis

Dose range: 50 mg/kg/day divided BID

Freq: BID × 10 days

Susp 250 mg/5 mL

Age: ≥1 mo

Max: 1000 mg/day

First-line for GAS pharyngitis.

Caregiver handout →

Safety, pregnancy/lactation & referral

Pregnancy: Compatible — first-line for many infections.

Lactation: Compatible — small amounts in milk, rarely causes infant rash/diarrhea.

Safety notes

Complete full 10-day course to prevent rheumatic fever
Shake suspension well; refrigerate

Contraindications

PCN or cephalosporin anaphylaxis
Infectious mononucleosis (rash risk)

When to call a specialist / ED

Recurrent GAS (≥7 episodes/year) → ENT
Peritonsillar abscess or trismus → ED
PSGN suspicion (dark urine, edema) → PCP

Anaphylaxis emergency card →

Amoxicillin (high-dose)

Antibiotic

Acute otitis media, sinusitis

Dose range: 80–90 mg/kg/day divided BID

Freq: BID × 5–10 days (age-based)

Susp 400 mg/5 mL

Age: ≥6 mo – ≤12 y (then adult dosing)

Max: 3000 mg/day

10 d if <2 y or severe; 5–7 d if ≥2 y and mild.

Caregiver handout →

Safety, pregnancy/lactation & referral

Pregnancy: Compatible.

Lactation: Compatible.

Safety notes

Reassess at 48–72 h if not improving
Diarrhea common — hold if severe

Contraindications

PCN allergy
Amoxicillin use in prior 30 days (use amox-clav instead)

When to call a specialist / ED

Mastoiditis (postauricular swelling/erythema) → ED
Recurrent AOM (≥3 in 6 mo or ≥4 in 12 mo) → ENT
Persistent effusion >3 mo with hearing concerns → ENT/audiology

Anaphylaxis emergency card →

Amoxicillin-clavulanate

Antibiotic

AOM (tx failure), sinusitis, bite wounds

Dose range: 90 mg/kg/day amox component divided BID

Freq: BID × 7–10 days

Susp 600 mg/5 mL (ES)

Age: ≥3 mo

Max: 4000 mg/day

Use ES formulation to limit clavulanate GI upset.

Caregiver handout →

Safety, pregnancy/lactation & referral

Pregnancy: Compatible.

Lactation: Compatible.

Safety notes

Take with food to reduce GI upset
Use ES (600 mg/5 mL) — do not substitute lower-strength suspensions gram-for-gram

Contraindications

PCN allergy
Prior amox-clav cholestatic hepatitis

When to call a specialist / ED

Deep hand/face bite or tendon involvement → surgery/ED
Orbital/periorbital cellulitis → ED
Failure after 72 h of amox-clav → PCP/ID

Anaphylaxis emergency card →

Cephalexin

Antibiotic

Skin/soft tissue, strep (PCN allergy — non-anaphylactic)

Dose range: 25–50 mg/kg/day divided QID

Freq: QID × 7–10 days

Susp 250 mg/5 mL

Age: ≥1 mo

Max: 4000 mg/day

TID acceptable for mild cases.

Caregiver handout →

Safety, pregnancy/lactation & referral

Pregnancy: Compatible.

Lactation: Compatible.

Safety notes

Does not cover MRSA — add/switch to TMP-SMX or clinda if suspected
QID dosing critical to maintain levels

Contraindications

Cephalosporin allergy
Prior anaphylaxis to any beta-lactam

When to call a specialist / ED

Abscess >5 cm, on face, or systemic signs → I&D / ED
Spreading cellulitis despite 48 h therapy → PCP/ED

Anaphylaxis emergency card →

Cefdinir

Antibiotic

AOM, sinusitis (PCN allergy)

Dose range: 14 mg/kg/day divided QD or BID

Freq: QD or BID × 5–10 days

Susp 125 mg/5 mL

Age: ≥6 mo

Max: 600 mg/day

May cause red/orange stool with iron — benign.

Caregiver handout →

Safety, pregnancy/lactation & referral

Pregnancy: Compatible.

Lactation: Compatible.

Safety notes

Separate from iron/antacids by ≥2 h (chelation)
Red stool is chelation, not blood — reassure

Contraindications

Cephalosporin allergy
History of PCN-induced anaphylaxis

When to call a specialist / ED

Mastoiditis or orbital cellulitis → ED
Recurrent AOM → ENT

Anaphylaxis emergency card →

Azithromycin

Antibiotic

Pertussis, atypical PNA, PCN-allergic strep

Dose range: 10 mg/kg day 1, then 5 mg/kg days 2–5

Freq: QD × 5 days

Susp 200 mg/5 mL

Age: ≥6 mo

Max: 500 mg/dose

Rising GAS macrolide resistance — verify susceptibility.

Caregiver handout →

Safety, pregnancy/lactation & referral

Pregnancy: Use with caution — reserve for clear indication.

Lactation: Compatible — monitor infant for GI upset.

Safety notes

QT prolongation risk — screen for cardiac history and concurrent QT-prolonging meds
Infants <1 mo: pyloric stenosis risk

Contraindications

Prior cholestatic jaundice with macrolides
Long-QT syndrome

When to call a specialist / ED

Pertussis in infant <6 mo → hospitalize/pediatrics
PNA with hypoxia, retractions, or dehydration → ED
Syncope or palpitations on therapy → ED

Anaphylaxis emergency card →

TMP-SMX

Antibiotic

UTI, MRSA SSTI

Dose range: 8–12 mg/kg/day TMP divided BID

Freq: BID × 3–10 days

Susp 40/200 mg per 5 mL

Age: ≥2 mo

Max: 320 mg/day

Avoid <2 mo, G6PD deficiency, sulfa allergy.

Caregiver handout →

Safety, pregnancy/lactation & referral

Pregnancy: AVOID in 1st and 3rd trimesters (neural tube, kernicterus).

Lactation: Compatible after 1 month if infant is healthy and full-term; avoid if G6PD or jaundiced.

Safety notes

Encourage fluids to reduce crystalluria
Watch for rash — stop immediately if SJS/TEN features (mucosal involvement, blistering)

Contraindications

Age <2 mo
Sulfa allergy
G6PD deficiency
Megaloblastic anemia (folate deficiency)
Pregnancy 1st/3rd trimester

When to call a specialist / ED

Any mucosal rash, blistering, or peeling → ED (SJS/TEN)
Suspected pyelonephritis (flank pain, high fever) → ED/PCP for IV therapy
Recurrent UTI (≥2 in 6 mo) → pediatric urology

Anaphylaxis emergency card →

Nitrofurantoin

Antibiotic

Uncomplicated UTI (cystitis)

Dose range: 5–7 mg/kg/day divided QID

Freq: QID × 5–7 days

Susp 25 mg/5 mL

Age: ≥1 mo

Max: 400 mg/day

Cystitis only — no tissue penetration for pyelonephritis.

Caregiver handout →

Safety, pregnancy/lactation & referral

Pregnancy: Compatible in 2nd trimester; AVOID at term (>38 wk) and 1st trimester if alternatives exist.

Lactation: Compatible after 1 month; avoid if infant <1 mo or G6PD deficient.

Safety notes

Take with food to improve absorption and reduce GI upset
Brown urine is expected — reassure

Contraindications

Age <1 mo
CrCl <60 mL/min
G6PD deficiency
Suspected pyelonephritis or urosepsis

When to call a specialist / ED

Flank pain, high fever, or vomiting → ED
Recurrent UTI → pediatric urology
Any GU anomaly (VUR, hydronephrosis) → urology

Anaphylaxis emergency card →

Oseltamivir

Antiviral

Influenza tx (start ≤48 h)

Dose range: ≤15 kg 30 mg BID · 15–23 kg 45 mg BID · 23–40 kg 60 mg BID · >40 kg 75 mg BID

Freq: BID × 5 days

Susp 6 mg/mL

Age: ≥2 wk

Max: —

Prophylaxis is once-daily at the same weight-based dose.

Caregiver handout →

Safety, pregnancy/lactation & referral

Pregnancy: Compatible — benefits usually outweigh risks in confirmed influenza.

Lactation: Compatible.

Safety notes

Best benefit if started <48 h from symptom onset, but still consider in high-risk or hospitalized
N/V common — give with food
Monitor for neuropsychiatric events (esp. adolescents)

Contraindications

Hypersensitivity to oseltamivir
Age <2 wk (not established)

When to call a specialist / ED

Infant <3 mo with flu → pediatrics
Hypoxia, dehydration, altered mental status → ED
Abrupt behavioral change on therapy → PCP/ED

Anaphylaxis emergency card →

Mupirocin 2% ointment

Antifungal / Topical

Impetigo (limited lesions)

Dose range: Apply to lesions

Freq: TID × 5 days

Topical

Age: ≥2 mo

Max: —

Switch to oral if extensive or bullous.

Caregiver handout →

Safety, pregnancy/lactation & referral

Pregnancy: Compatible (topical).

Lactation: Compatible (avoid on nipples if directly nursing).

Safety notes

Wash hands after application; keep lesions covered to limit spread
Do not use on mucous membranes or in eyes

Contraindications

Hypersensitivity to mupirocin or polyethylene glycol
Extensive open wounds / burns (systemic PEG absorption)

When to call a specialist / ED

Bullous impetigo, >2% BSA, or systemic signs → PCP for oral abx
Recurrent MRSA colonization → PCP for decolonization protocol

Anaphylaxis emergency card →

Nystatin oral suspension

Antifungal / Topical

Oral thrush

Dose range: Infants 2 mL (200,000 U) QID; children 4–6 mL QID

Freq: QID × 7–14 days (× 48 h after clear)

Susp 100,000 U/mL

Age: Any

Max: —

Swab in mouth; do not feed for 30 min after.

Caregiver handout →

Safety, pregnancy/lactation & referral

Pregnancy: Compatible.

Lactation: Compatible.

Safety notes

Also treat maternal nipples if breastfeeding (topical nystatin)
Sterilize/replace pacifiers and bottle nipples

Contraindications

Hypersensitivity to nystatin

When to call a specialist / ED

Thrush not clearing after 14 days → PCP (consider immunodeficiency)
Thrush in child >12 mo with no risk factors → PCP
Difficulty feeding, dehydration → PCP/ED

Anaphylaxis emergency card →

Cetirizine

Antihistamine

Allergic rhinitis, urticaria

Dose range: 6–23 mo 2.5 mg QD · 2–5 y 2.5–5 mg QD · ≥6 y 5–10 mg QD

Freq: QD

Syrup 5 mg/5 mL

Age: ≥6 mo

Max: 10 mg/day

Less sedating; preferred over diphenhydramine for chronic use.

Caregiver handout →

Safety, pregnancy/lactation & referral

Pregnancy: Compatible — preferred second-generation antihistamine.

Lactation: Compatible.

Safety notes

May cause mild sedation in ~10%
Reduce dose in renal impairment

Contraindications

Hypersensitivity to cetirizine or hydroxyzine
Age <6 mo

When to call a specialist / ED

Anaphylaxis (respiratory, hypotension, GI+skin) → epinephrine + ED
Chronic urticaria >6 wk → allergy/immunology

Anaphylaxis emergency card →

Loratadine

Antihistamine

Allergic rhinitis, urticaria

Dose range: 2–5 y 5 mg QD · ≥6 y 10 mg QD

Freq: QD

Syrup 5 mg/5 mL

Age: ≥2 y

Max: 10 mg/day

Non-sedating.

Caregiver handout →

Safety, pregnancy/lactation & referral

Pregnancy: Compatible.

Lactation: Compatible.

Safety notes

Reduce to every-other-day in hepatic impairment

Contraindications

Hypersensitivity to loratadine or desloratadine
Age <2 y (OTC labeling)

When to call a specialist / ED

Anaphylaxis → epinephrine + ED
Persistent symptoms despite daily therapy → allergy

Anaphylaxis emergency card →

Diphenhydramine

Antihistamine

Acute allergic reaction (short-term)

Dose range: 1.25 mg/kg q6h PRN

Freq: q6h PRN

Liquid 12.5 mg/5 mL

Age: ≥2 y (avoid OTC use <2 y)

Max: 50 mg/dose · 300 mg/day

Sedating; not for chronic rhinitis. Paradoxical excitation possible.

Caregiver handout →

Safety, pregnancy/lactation & referral

Pregnancy: Compatible — often used for nausea and allergy in pregnancy.

Lactation: Use with caution — may reduce milk supply and sedate infant. Prefer loratadine/cetirizine.

Safety notes

Never combine with other sedating antihistamines or OTC cold meds containing DPH
Warn caregivers about paradoxical hyperactivity

Contraindications

Age <2 y (OTC labeling — respiratory depression risk)
Narrow-angle glaucoma
Concurrent MAOIs
Neonates/premature infants

When to call a specialist / ED

Any anaphylaxis → epinephrine IM + ED (DPH is adjunct, NOT first-line)
Overdose (agitation, seizures, wide-complex tachycardia) → ED immediately

Anaphylaxis emergency card →

Acetaminophen

Analgesic / Antipyretic

Fever, pain

Dose range: 15 mg/kg q4–6h

Freq: q4–6h PRN

Susp 160 mg/5 mL

Age: Any

Max: 1000 mg/dose · 4000 mg/day

Max 75 mg/kg/day (pediatric ceiling) or 4 g/day.

Caregiver handout →

Safety, pregnancy/lactation & referral

Pregnancy: Compatible — preferred analgesic/antipyretic in pregnancy.

Lactation: Compatible.

Safety notes

Use weight, not age, to dose
Warn about combo OTC/Rx products (cough syrups, oxycodone-APAP) to prevent double-dosing
Use the dropper/syringe that came with the product

Contraindications

Severe hepatic impairment or active liver disease
Known APAP hypersensitivity

When to call a specialist / ED

Fever ≥38 °C in infant <3 mo → ED
Suspected overdose (>150 mg/kg single or >75 mg/kg/day chronic) → ED / Poison Control 1-800-222-1222
Fever >5 days or ill appearance → PCP/ED

Anaphylaxis emergency card →

Ibuprofen

Analgesic / Antipyretic

Fever, pain, inflammation

Dose range: 10 mg/kg q6–8h

Freq: q6–8h PRN

Susp 100 mg/5 mL

Age: ≥6 mo

Max: 400 mg/dose · 1200 mg/day

Give with food. Avoid if dehydrated or with renal disease.

Caregiver handout →

Safety, pregnancy/lactation & referral

Pregnancy: AVOID after 20 weeks (fetal renal dysfunction, ductus closure).

Lactation: Compatible.

Safety notes

Ensure adequate hydration before dosing
Avoid concurrent nephrotoxins (aminoglycosides, ACE-I)
Do not use with other NSAIDs

Contraindications

Age <6 mo
Dehydration or hypovolemia
CKD or AKI
Active GI bleed / peptic ulcer
Suspected varicella or dengue (bleeding risk)
Aspirin-sensitive asthma

When to call a specialist / ED

Signs of GI bleed (melena, hematemesis) → ED
Suspected overdose → Poison Control / ED
Fever with petechial rash → ED

Anaphylaxis emergency card →

Dexamethasone

Steroid

Croup (single-dose)

Dose range: 0.6 mg/kg × 1 (PO/IM)

Freq: × 1 dose

Elixir 0.5 mg/5 mL

Age: ≥3 mo

Max: 16 mg/dose

Refer moderate–severe croup (stridor at rest) urgently.

Caregiver handout →

Safety, pregnancy/lactation & referral

Pregnancy: Short-term use compatible; avoid chronic first-trimester use.

Lactation: Compatible for single-dose or short course.

Safety notes

Single-dose systemic effect is minimal; still document exposure
Bitter taste — mix with small amount of juice or use IM if refusing PO

Contraindications

Active untreated systemic fungal infection
Recent live vaccine within 4 wk (relative)
Hypersensitivity to dexamethasone

When to call a specialist / ED

Stridor at rest, retractions, or hypoxia → ED (nebulized epinephrine)
Suspected epiglottitis (drooling, tripod, toxic) → ED — do NOT examine throat
Recurrent croup or age >6 y → ENT/pulm

Anaphylaxis emergency card →

Prednisolone

Steroid

Asthma exacerbation

Dose range: 1–2 mg/kg/day

Freq: QD or divided BID × 3–5 days

Susp 15 mg/5 mL

Age: Any

Max: 60 mg/day

Refer or send to ED if severe or hypoxic.

Caregiver handout →

Safety, pregnancy/lactation & referral

Pregnancy: Compatible for short bursts.

Lactation: Compatible.

Safety notes

No taper needed for ≤7-day burst
Reassess response at 24–48 h
Monitor blood glucose if diabetic

Contraindications

Active untreated systemic fungal or bacterial infection
Live vaccines during high-dose therapy
Hypersensitivity

When to call a specialist / ED

SpO₂ <92%, silent chest, or exhaustion → ED
≥2 ED visits or ≥2 oral steroid bursts in 12 mo → pediatric pulm/allergy
Suspected anaphylaxis-triggered exacerbation → epinephrine + ED

Anaphylaxis emergency card →

Erythromycin ophthalmic 0.5%

Ophthalmic / Otic

Bacterial conjunctivitis

Dose range: Ribbon to affected eye(s)

Freq: QID × 5–7 days

Ointment

Age: Any

Max: —

Non-stinging; preferred in young children.

Caregiver handout →

Safety, pregnancy/lactation & referral

Pregnancy: Compatible.

Lactation: Compatible.

Safety notes

Blurs vision briefly after application
Do not let tube tip touch eye — contamination risk

Contraindications

Hypersensitivity to erythromycin
Viral or fungal keratitis

When to call a specialist / ED

Photophobia, vision changes, or eye pain → ophthalmology
Contact-lens wearer with red eye → ophthalmology (Pseudomonas risk)
Neonate <28 days with conjunctivitis → ED (rule out gonococcal/chlamydial/HSV)
Hyperacute purulent discharge → ED

Anaphylaxis emergency card →

Ofloxacin 0.3% otic

Ophthalmic / Otic

Otitis externa; AOM with tubes/perforation

Dose range: 5 drops to affected ear

Freq: BID × 7 days

Otic solution

Age: ≥6 mo (≥1 y for OE labeling)

Max: —

Safe with perforated TM (unlike neomycin).

Caregiver handout →

Safety, pregnancy/lactation & referral

Pregnancy: Compatible (topical — minimal absorption).

Lactation: Compatible.

Safety notes

Warm bottle in hand before instillation to reduce vertigo
Have patient lie with treated ear up for 5 minutes
Keep ear canal dry between doses

Contraindications

Fluoroquinolone hypersensitivity
Viral otic infection (HSV/varicella)

When to call a specialist / ED

Postauricular swelling/erythema (mastoiditis) → ED
Facial nerve weakness → ED
Malignant otitis externa in immunocompromised → ED/ID
No improvement after 7 days → ENT

Anaphylaxis emergency card →

For licensed clinician reference only. This content is a quick-reference aid and is not medical advice. Verify every dose, indication, contraindication, and interaction against current manufacturer labeling and authoritative guidelines (AAP, CDC, IDSA, Sanford Guide, LactMed) before prescribing. The authors and publisher accept no liability for clinical decisions made using this tool.