{ "schema_version": 1, "kind": "condition", "id": "paediatric-uti", "name": "Urinary tract infection in children", "category": "infectious", "sources": "Urinary Tract Infections In Children - StatPearls (NCBI Bookshelf NBK599548) - https://www.ncbi.nlm.nih.gov/books/NBK599548/ · Urinary tract infection in under 16s: diagnosis and management - NICE Guideline NG224 (NCBI Bookshelf NBK588844) - https://www.ncbi.nlm.nih.gov/books/NBK588844/ · Urinary tract infection in children - disease-level clinical article (paediatric-uti-full.txt) · Urinary tract infection in children - disease-level clinical article (paediatric-uti-clinical.txt)", "review_status": "reviewed", "verified_against": "Urinary Tract Infections In Children - StatPearls (NCBI Bookshelf NBK599548) - https://www.ncbi.nlm.nih.gov/books/NBK599548/ · Urinary tract infection in under 16s: diagnosis and management - NICE Guideline NG224 (NCBI Bookshelf NBK588844) - https://www.ncbi.nlm.nih.gov/books/NBK588844/ · Urinary tract infection in children - disease-level clinical article (paediatric-uti-full.txt) · Urinary tract infection in children - disease-level clinical article (paediatric-uti-clinical.txt)", "verified_date": "2026-08", "treatments": [ { "id": 1304, "generic": "Cephalexin", "line": 1, "is_adjunct": false, "form": "oral.liquid", "strength_mg": 250.0, "adult_dose": "250-1,000 mg every 6 hours, or 500 mg every 12 hours (maximum 4 g/day)", "adult_duration": "3-7 days for cystitis over 2 years; 7-14 days under 2 years or in pyelonephritis", "dose_source": "Egyptian National Drug Formulary - Antimicrobial 2023 (cephalexin monograph)", "rationale": "A first-generation cephalosporin. The cited disease article says first-generation cephalosporins such as cephalexin cover the usual urinary organisms well, are well tolerated, are widely available and are cheap, with the one drawback that they must be given at least three times a day. The formulary's own indication list for this drug names genitourinary tract infection caused by E. coli, Proteus mirabilis and Klebsiella pneumoniae - the three organisms that cause most childhood urinary infection - so the drug and the indication come from the same monograph as the dose.", "cautions": [ "TABLETS AND SUSPENSION ARE NOT INTERCHANGEABLE MILLIGRAM FOR MILLIGRAM. The formulary states that the tablet and the oral suspension are not bioequivalent and must not be substituted on a mg-per-mg basis.", "Do not give to a child with a known allergy to cephalexin, to another cephalosporin, or to any component of the preparation.", "TAKE THE URINE BEFORE THE FIRST DOSE. The specimen must be collected for urinalysis and for culture before any antibiotic is given, or the culture that would have named the organism is lost.", "Change the antibiotic to whatever the culture says once susceptibilities come back. This choice is empirical - it is what to start, not what to finish on." ], "peds_mgkg_low": 25.0, "peds_mgkg_high": 50.0, "peds_max_mg": 2000.0, "peds_basis": "day", "peds_unit": "mg", "peds_note": "Mild to moderate infection: 25-50 mg/kg/day divided every 6 or 12 hours, maximum 2,000 mg/day. Severe infection (the formulary gives bone and joint infection as its example): 75-100 mg/kg/day divided every 6 to 8 hours, maximum 4,000 mg/day.", "peds_min_weight_kg": null, "peds_max_weight_kg": null, "peds_age_min_months": null, "peds_age_max_months": null, "peds_age_bands": null, "peds_doses": [ { "weight_kg": 10, "low_mg": 250, "high_mg": 500, "capped": false }, { "weight_kg": 20, "low_mg": 500, "high_mg": 1000, "capped": false }, { "weight_kg": 30, "low_mg": 750, "high_mg": 1500, "capped": false }, { "weight_kg": 40, "low_mg": 1000, "high_mg": 2000, "capped": false } ], "brands": [ { "trade_name": "AMTHROST 250MG/5ML SUSP. 60ML", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "SIGMA > SABAA", "price_egp": 4.5, "pack_count": null, "unit_price": null, "strength_mg": 250.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "CEPHOXIN 250MG/5ML DRY SUSP. 60 ML", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "PHARCO B", "price_egp": 6.5, "pack_count": null, "unit_price": null, "strength_mg": 250.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "CEPHALEXIN 250MG/5ML SUSP. 60ML USP24", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "ARAB DRUG COMPANY (ADCO)", "price_egp": 8.0, "pack_count": null, "unit_price": null, "strength_mg": 250.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "CEPHLEX 250 MG/5 ML SUSP. 60ML", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "KAHIRA", "price_egp": 10.5, "pack_count": null, "unit_price": null, "strength_mg": 250.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "MEDICEFLEXIN 250MG/5ML SUSP. 100ML", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "T3A PHARMA > RIVA PHARMA S.A.E.", "price_egp": 14.25, "pack_count": null, "unit_price": null, "strength_mg": 250.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "KEFLEX 250MG/5ML PD. FOR ORAL SUSP. 60 ML", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "HIKMA PHARMA", "price_egp": 37.0, "pack_count": null, "unit_price": null, "strength_mg": 250.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "AMTHROST 125MG/5ML SUSP. 60ML", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "SIGMA > SABAA", "price_egp": 4.0, "pack_count": null, "unit_price": null, "strength_mg": 125.0, "exact_strength": false, "exact_form": false, "discontinued": false, "also_contains": null }, { "trade_name": "CEPHOXIN 125MG/5ML DRY SUSP. 60 ML", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "PHARCO B", "price_egp": 6.0, "pack_count": null, "unit_price": null, "strength_mg": 125.0, "exact_strength": false, "exact_form": false, "discontinued": false, "also_contains": null } ], "condition_id": "paediatric-uti" }, { "id": 1305, "generic": "Amoxicillin + Clavulanic acid", "line": 1, "is_adjunct": false, "form": "oral.liquid", "strength_mg": 457.0, "adult_dose": "Simple cystitis 500 mg twice daily; complicated infection or pyelonephritis 875 mg twice daily", "adult_duration": "3-7 days for cystitis over 2 years; 10-14 days for pyelonephritis", "dose_source": "Egyptian National Drug Formulary - Antimicrobial 2023 (amoxicillin and clavulanate monograph)", "rationale": "The cited disease article names amoxicillin-clavulanate, alongside second and third generation cephalosporins, as a preferred option for an acute uncomplicated urinary infection in a child. The formulary lists urinary tract infection among this drug's oral indications and gives the paediatric milligram-per-kilogram rule quoted below.", "cautions": [ "A CHILD UNDER 40 KG MUST NOT BE GIVEN THE 250 MG FILM-COATED TABLET. The formulary is explicit: that preparation carries a high dose of clavulanic acid for a small child.", "READ THE RATIO ON THE BOTTLE BEFORE CALCULATING. 4:1 is given three times a day, 7:1 and 14:1 twice a day. Using the wrong frequency for the bottle in hand is the mistake this drug invites.", "Do not give to a child with a known allergy to penicillins or cephalosporins, or with previous cholestatic jaundice or liver upset on amoxicillin-clavulanate.", "TAKE THE URINE BEFORE THE FIRST DOSE, and change to a culture-guided antibiotic when susceptibilities return." ], "peds_mgkg_low": 20.0, "peds_mgkg_high": 40.0, "peds_max_mg": 1500.0, "peds_basis": "day", "peds_unit": "mg", "peds_note": "THE DOSE DEPENDS ON WHICH SUSPENSION IS IN YOUR HAND, and the milligrams are of the amoxicillin half only. The grid above is the 4:1 suspension (125/31.25 or 250/62.5): 20-40 mg amoxicillin/kg/day in three divided doses, maximum 1,500 mg/day. For the 7:1 suspensions (200/28.5, 400/57) the formulary gives 25-45 mg amoxicillin/kg/day in two divided doses, maximum 1,750 mg/day. The 125 mg/5 mL suspension is the only preparation the formulary allows in a neonate or an infant under 12 weeks.", "peds_min_weight_kg": null, "peds_max_weight_kg": null, "peds_age_min_months": null, "peds_age_max_months": null, "peds_age_bands": null, "peds_doses": [ { "weight_kg": 10, "low_mg": 200, "high_mg": 400, "capped": false }, { "weight_kg": 20, "low_mg": 400, "high_mg": 800, "capped": false }, { "weight_kg": 30, "low_mg": 600, "high_mg": 1200, "capped": false }, { "weight_kg": 40, "low_mg": 800, "high_mg": 1500, "capped": true } ], "brands": [ { "trade_name": "AMOCLAWIN 457MG/5ML PD. FOR ORAL SUSP. 60ML", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "SEDICO > SANOFI", "price_egp": 22.5, "pack_count": null, "unit_price": null, "strength_mg": 457.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "E-MOXCLAV 457MG SUSP. 70 ML", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "EIPICO", "price_egp": 24.0, "pack_count": null, "unit_price": null, "strength_mg": 457.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "DEXICLAVE 457MG/5ML SUSP. 60 ML", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "RAMEDA > NOVELL PHARMA", "price_egp": 27.5, "pack_count": null, "unit_price": null, "strength_mg": 457.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "KLAVOX 457MG/5ML SUSP. 70ML", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "SPIMACO > EIMC", "price_egp": 48.0, "pack_count": null, "unit_price": null, "strength_mg": 457.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "FONDACLAV 457MG/5ML ORAL SUSP. 75 ML", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "GYPTO PHARMA", "price_egp": 78.0, "pack_count": null, "unit_price": null, "strength_mg": 457.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "NEW-CLAV 457MG/5ML SUSP. 80ML", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "SIGMA TEC > ANDALOUS PHARMA", "price_egp": 88.0, "pack_count": null, "unit_price": null, "strength_mg": 457.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "MEGAMOX 457MG/5ML SUSP. 70ML", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "AL JAZEERA PHARMACEUTICAL > HIKMA PHARMA", "price_egp": 100.0, "pack_count": null, "unit_price": null, "strength_mg": 457.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "AUGMENTIN 457MG/5ML SUSP. 70 ML", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "MUP > GLAXO SMITHKLINE", "price_egp": 137.0, "pack_count": null, "unit_price": null, "strength_mg": 457.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "LARYNCLAVE 125/31 PD. FOR ORAL SUSP. 70ML", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "MISR > AL ROWAD PHARMACEUTICAL INDUSTRIAL CO.", "price_egp": 8.0, "pack_count": null, "unit_price": null, "strength_mg": null, "exact_strength": false, "exact_form": false, "discontinued": false, "also_contains": null }, { "trade_name": "MEGACLAVOX 156MG/5ML PD. FOR SUSP. 60 ML", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "CID", "price_egp": 8.0, "pack_count": null, "unit_price": null, "strength_mg": 156.0, "exact_strength": false, "exact_form": false, "discontinued": false, "also_contains": null } ], "condition_id": "paediatric-uti" }, { "id": 1307, "generic": "Ceftriaxone", "line": 1, "is_adjunct": false, "form": "injection", "strength_mg": 500.0, "adult_dose": "1-2 g once daily by intramuscular or intravenous injection (maximum 2 g daily for a urinary infection)", "adult_duration": "until the child can keep an oral antibiotic down, then switch", "dose_source": "Egyptian National Drug Formulary - Antimicrobial 2023 (ceftriaxone monograph)", "rationale": "The injection for the child who cannot be treated by mouth. The cited disease article says the parenteral route is advised for any infant of 2 months or under, and for any child who looks toxic, who has bacteraemia or sepsis, whose circulation is unstable, who is immunocompromised, who cannot keep an oral medicine down, or who has not responded to one. The formulary names complicated urinary tract infection including pyelonephritis among this drug's indications and gives the paediatric rule below. Give it as part of getting the child to hospital, not instead of it.", "cautions": [ "UNDER 3 MONTHS, REFER - DO NOT SIMPLY TREAT. NICE NG224 sends a baby under 3 months with a suspected urinary infection to paediatric specialist care with an urgent urine microscopy and culture. An injection given on the way is not a substitute for that referral.", "NEVER WITH AN INTRAVENOUS CALCIUM-CONTAINING FLUID IN A NEONATE (28 days or under). The formulary makes this an absolute contraindication.", "NOT IN A JAUNDICED NEWBORN, especially a premature one: the formulary states that ceftriaxone displaces bilirubin from albumin.", "Do not give to a child with a known allergy to ceftriaxone or another cephalosporin.", "Oral antibiotics work as well as intravenous ones in a child who is not toxic, including in acute pyelonephritis. Switch to the mouth as soon as the child improves and can keep a medicine down." ], "peds_mgkg_low": 50.0, "peds_mgkg_high": 75.0, "peds_max_mg": 1000.0, "peds_basis": "dose", "peds_unit": "mg", "peds_note": "Infants, children and adolescents, mild to moderate infection: 50-75 mg/kg as a single daily dose by IM or IV, maximum 1,000 mg a day. Premature and term neonates: 50 mg/kg every 24 hours. The formulary caps most infections other than endocarditis and meningitis at 2 g daily.", "peds_min_weight_kg": null, "peds_max_weight_kg": null, "peds_age_min_months": null, "peds_age_max_months": null, "peds_age_bands": null, "peds_doses": [ { "weight_kg": 10, "low_mg": 500, "high_mg": 750, "capped": false }, { "weight_kg": 20, "low_mg": 1000, "high_mg": 1000, "capped": true }, { "weight_kg": 30, "low_mg": 1000, "high_mg": 1000, "capped": true }, { "weight_kg": 40, "low_mg": 1000, "high_mg": 1000, "capped": true } ], "brands": [ { "trade_name": "TRIXOMASH 500MG VIAL FOR I.V. INJ.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "RAMEDA > MASH PREMIERE", "price_egp": 16.5, "pack_count": null, "unit_price": null, "strength_mg": 500.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "WINTRIAXONE 500 MG PD. FOR I.V INJ.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "SANOFI", "price_egp": 21.75, "pack_count": null, "unit_price": null, "strength_mg": 500.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "CEFAXONE 500MG I.V. VIAL", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "PHARCO B", "price_egp": 25.25, "pack_count": null, "unit_price": null, "strength_mg": 500.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "TRIAXONE 500MG VIAL FOR I.M. INJ.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "TABUK PHARMACEUTICAL MANUFACTURING COMPANY > TABUK PHARMA", "price_egp": 36.0, "pack_count": null, "unit_price": null, "strength_mg": 500.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "TRIAMERICAN 500 MG I.M. VIAL", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "RAMEDA > PAXAL", "price_egp": 46.0, "pack_count": null, "unit_price": null, "strength_mg": 500.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "EPICEPHIN 500 MG I.V. VIAL", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "EIPICO", "price_egp": 47.0, "pack_count": null, "unit_price": null, "strength_mg": 500.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "CEFAXOTREZ 500 MG I.M. VIAL", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "RAMEDA > BOSTON CARE PHARMACEUTICALS", "price_egp": 63.0, "pack_count": null, "unit_price": null, "strength_mg": 500.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "CEFAXOTREZ 500 MG I.V. VIAL", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "RAMEDA > BOSTON CARE PHARMACEUTICALS", "price_egp": 63.0, "pack_count": null, "unit_price": null, "strength_mg": 500.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null } ], "condition_id": "paediatric-uti" }, { "id": 1308, "generic": "Referral & safety-netting (no drug therapy)", "line": 1, "is_adjunct": false, "form": null, "strength_mg": null, "adult_dose": null, "adult_duration": null, "dose_source": "Urinary tract infection in under 16s: diagnosis and management - NICE Guideline NG224 (NCBI Bookshelf NBK588844) - https://www.ncbi.nlm.nih.gov/books/NBK588844/", "rationale": "The antibiotic choices for a urinary infection are the same drugs a child would get anywhere and are dosed on the uti-uncomplicated card. What is specific to children is who must be referred rather than treated, how the urine has to be collected before it means anything, and which child needs a scan afterwards. No antibiotic row is printed here because neither cached article states a milligram-per-kilogram amount, and a dose carried across from an adult card is a dose nobody checked.", "cautions": [ "UNDER 3 MONTHS, DO NOT TREAT - REFER - a baby under 3 months in whom a UTI is suspected (NG224 table 1; recommendation 1.1.2) goes to paediatric specialist care, with a urine sample sent for microscopy and culture urgently. NICE then hands the baby to the fever pathway rather than to a prescription.", "A NEWBORN GOES DOWN THE NEONATAL ROUTE, NOT THE URINE ROUTE - within the first 28 days, a bacterial infection suspected or confirmed is one NICE sends elsewhere: assess and manage it by the NICE guideline on neonatal infection and the antibiotics used to prevent and to treat it.", "PARENTERAL THERAPY, NOT ORAL, FOR THE VERY YOUNG OR THE VERY UNWELL - antibiotics are advised by the parenteral route in any infant of 2 months or under, and in any child who looks toxic, who has bacteraemia or sepsis, whose circulation is unstable, who is immunocompromised, who cannot keep an oral medicine down, or who has failed to respond to one.", "GET THE URINE BEFORE THE ANTIBIOTIC - take the urine sample from the child or young person before any antibiotic is given. The specimen is collected for urinalysis and for culture both, and it is collected first.", "A BAG SPECIMEN CANNOT DIAGNOSE AN INFECTION - urine caught in a bag may be put through urinalysis, but it must NOT be cultured: bacteria living on the skin around the genitals, and nowhere in the urinary tract, can contaminate it. Cultures from a perineal bag throw up false positives at a rate that cannot be accepted, and count only when the result comes back negative. NICE adds that cotton wool balls, gauze and sanitary towels must NOT be used to collect urine from a baby or a child.", "THE DIPSTICK ONLY WORKS AS A PAIR - a test strip is validated for ruling infection in or out only when nitrite, which marks some gram-negative organisms, and leucocyte esterase (LE), which marks white cells, are read together. Blood on the stick, or protein, is not a dependable sign of UTI.", "HOW NICE WANTS THE DIPSTICK ACTED ON, 3 MONTHS TO 3 YEARS - where leucocyte esterase and nitrite are both negative, do NOT give an antibiotic, and do NOT send anything for microscopy and culture - unless recommendation 1.1.21 supplies at least 1 reason to send it. Where either is positive, or both are, the sample goes for culture and antibiotics are given.", "HOW LONG TO TREAT, BY AGE AND BY LEVEL - for infants, for toddlers under 24 months, and for older children with pyelonephritis, the advised course runs 7 to 14 days. An older child with cystitis may need only 3 to 7 days. Acute pyelonephritis can be treated orally for 10 to 14 days, or intravenously for 2 to 4 days and then by mouth.", "REASSESS AT 48 HOURS IF NOTHING IS IMPROVING - in UTI, acute pyelonephritis included, oral antibiotics work as well as intravenous ones so long as the child is not toxic. NICE counts failing to respond to a suitable antibiotic inside 48 hours as one of the marks of an atypical infection.", "WHAT COUNTS AS ATYPICAL, WHICH IS WHAT DRIVES THE SCAN - NICE's own box holds: a child who is seriously ill; a poor stream; a mass in the abdomen or the bladder; a creatinine that has risen; septicaemia; no response to a suitable antibiotic inside 48 hours; and an organism that is not E. coli.", "AND WHAT COUNTS AS RECURRENT - two or more episodes involving the upper tract (acute pyelonephritis); or 1 upper-tract episode together with 1 or more lower-tract episodes (cystitis); or three or more lower-tract episodes on their own.", "WHO GETS AN ULTRASOUND, AND WHEN - a baby or child with an atypical UTI (see box 1) has the urinary tract scanned while the infection is still running. A baby under 6 months whose first UTI responds to treatment is scanned inside 6 weeks of it. Over 6 months, do NOT routinely scan a first UTI that responds, unless it was atypical. And after a lower-tract infection the scan (inside 6 weeks) is reserved for those under 6 months, or those whose infections keep coming back.", "DO NOT ORDER A MICTURATING CYSTOGRAM AFTER ONE INFECTION - a VCUG as a matter of routine is NOT advised once a child has had a first UTI. Consider it ONLY where the ultrasound of kidneys and bladder has shown a hydroureter, hydronephrosis, scarring or something else suggestive, or where a febrile UTI has come back.", "NO PROPHYLACTIC ANTIBIOTIC AFTER A FIRST INFECTION - prophylaxis must NOT be given routinely to a baby or child after a first UTI, and must NOT be given at all for bacteriuria that is causing no symptoms.", "CONSTIPATION IS THE COMMONEST FIXABLE CAUSE OF REPEAT INFECTIONS - screening for bowel and bladder dysfunction and treating it prevents UTI, is safe, works, and is thought of far too little. Asking about constipation, about wetting in the daytime, and about holding on will find the children who have it. The measures listed are voiding to a timetable every 3 to 4 hours, drinking enough, and treating the constipation itself. As for cranberry juice, the evidence to recommend it for preventing UTI is not there.", "TELL THE FAMILY WHAT TO DO AT THE NEXT FEVER - where a child's UTIs keep returning, the parents are told to bring them to be seen promptly with any future febrile illness, so that it is caught early and treated in time - inside 48 hours - and the kidney is spared damage." ], "peds_mgkg_low": null, "peds_mgkg_high": null, "peds_max_mg": null, "peds_basis": null, "peds_unit": null, "peds_note": null, "peds_min_weight_kg": null, "peds_max_weight_kg": null, "peds_age_min_months": null, "peds_age_max_months": null, "peds_age_bands": null, "peds_doses": null, "brands": [], "condition_id": "paediatric-uti" }, { "id": 1306, "generic": "Nitrofurantoin", "line": 2, "is_adjunct": false, "form": "oral.liquid", "strength_mg": 50.0, "adult_dose": "50-100 mg four times daily", "adult_duration": "7 days, or at least 3 days after the urine is sterile", "dose_source": "Egyptian National Drug Formulary - Antimicrobial 2023 (nitrofurantoin monograph)", "rationale": "A urinary antiseptic that concentrates in the bladder urine. The formulary names acute uncomplicated cystitis as its indication and gives a paediatric rule from one month of age. It is kept at second line here for the reason the disease article gives: it does not reach the kidney, so it is the wrong drug the moment the infection is above the bladder - and in a young child that is hard to be sure of.", "cautions": [ "NOT FOR PYELONEPHRITIS, AND NOT WHEN YOU CANNOT EXCLUDE IT. The cited disease article states that nitrofurantoin does not penetrate the kidney tissue or the bloodstream well and is unsuitable for pyelonephritis, particularly in younger children.", "CONTRAINDICATED UNDER 1 MONTH OF AGE. The formulary bars it in a neonate because an immature red-cell enzyme system can lead to haemolytic anaemia.", "Contraindicated in anuria, oliguria or significant renal impairment (creatinine clearance under 60 mL/min), and after previous cholestatic jaundice or liver dysfunction on nitrofurantoin.", "The formulary notes rising resistance to this drug in some areas. Culture matters more here than with the cephalosporins.", "Give with food. The urine turns brown - warn the parent, it is harmless." ], "peds_mgkg_low": 5.0, "peds_mgkg_high": 7.0, "peds_max_mg": null, "peds_basis": "day", "peds_unit": "mg", "peds_note": "Children of 1 month and over: 5-7 mg/kg/day in four divided doses for 7 days, or for at least 3 days after the urine becomes sterile. For long-term suppression the formulary gives 1 mg/kg/day as a single dose or in two divided doses. For prevention of recurrence: 1-2 mg/kg/day, single bedtime dose or divided twice daily, maximum 100 mg/day.", "peds_min_weight_kg": null, "peds_max_weight_kg": null, "peds_age_min_months": null, "peds_age_max_months": null, "peds_age_bands": null, "peds_doses": [ { "weight_kg": 10, "low_mg": 50, "high_mg": 70, "capped": false }, { "weight_kg": 20, "low_mg": 100, "high_mg": 140, "capped": false }, { "weight_kg": 30, "low_mg": 150, "high_mg": 210, "capped": false }, { "weight_kg": 40, "low_mg": 200, "high_mg": 280, "capped": false } ], "brands": [ { "trade_name": "MACROFURAN 50 MG 30 CAPS.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "KAHIRA", "price_egp": 51.0, "pack_count": 30, "unit_price": 1.7, "strength_mg": 50.0, "exact_strength": true, "exact_form": false, "discontinued": false, "also_contains": null }, { "trade_name": "MEPAFURAN 50 MG 20 CAPS.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "MEPACO", "price_egp": 34.0, "pack_count": 20, "unit_price": 1.7, "strength_mg": 50.0, "exact_strength": true, "exact_form": false, "discontinued": false, "also_contains": null } ], "condition_id": "paediatric-uti" } ] }