*6.1.6.2.1 Chlortetracycline hydrochloride*

PO: administered every 6 hours at a dose of 25-50 mg/kg/day (Köksal & Reisli, 2002).

*6.1.6.2.2 Oxytetracycline* 

Child; PO: 25-50 mg/kg/day every 8 hours, IM: 15-20 mg/kg/day every 8-12 hours, IV: 10- 20 mg/kg/day every 12 hours (Eroğlu, 2002).

### **6.1.7 Other antimicrobial drugs**

### **6.1.7.1 Clindamycin**

It is a derivative of lincomycin. It inhibits protein synthesis. It is active against gram (+) cocci and anaerobes (Köksal & Reisli, 2002). Its metabolism in premature is highly variable (Kanmaz, 2010).

*Dose*: 5-7.5 mg/kg/dose IV slow infusion for 30 min. or PO (Kanmaz, 2010).

Newborn; (IM/IV), <7 days <2000g: 10 mg/kg/day every 12 hours >2000g: 15 mg/kg/day every 8 hours, >7 days <2000g: 15 mg/kg/day every 8 hours, >2000g: 20 mg/kg/day every 4 hours, infant and children; 10-25 mg/kg/day (PO) every 6-8 hours or 25-40 mg/kg/day IV, IM every 6-8 hours (Eroğlu, 2002).

*Side effects:* Such gastrointestinal symptoms as nausea, vomiting, nuisance, and diarrhea are frequent (Apak, 1996; Eroğlu, 2002). Pseudomembranous enterocolitis may develop. Given fast by infusion it may cause syncope and respiratory arrest. Cleocin, Clindan, Klinoksin are its derivatives (Eroğlu, 2002).

#### **6.1.7.2 Chloramphenicol**

It inhibits protein synthesis. It has wide spectrum. It is bacteriostatic for many organisms in low concentrations. Newborn; <14 days 25 mg/kg/day PO, IV, every 12 hours >14 days <2000g: 25 mg/kg/day PO, IV, every 4 hours, >2000g: 50 mg/kg/day PO, IV every 4 hours, infant and children; 50-100 mg/kg/day PO, every 6 hours IV 100 mg/kg/day every 4 hours (Eroğlu, 2002; Dökmeci, 2001).

*Side effects:* Non dose-related aplastic anemia is a rarely seen; but a serious complication. Dose-related bone marrow suppression is frequently seen and reversible (Eroğlu, 2002).

#### **6.1.7.3 Rifampicin**

It is an antimicrobial and antibacterial agent. It is used with at least one more antituberculosis agent in tuberculosis treatment. And administered as single dose 10-20 mg/kg/day PO (Dökmeci, 2001).

#### **6.1.7.4 Vancomycin**

It inhibits cell wall synthesis in gram (+) bacteria (Dökmeci, 2001).

*Uses:* Drug of choice for serious infections caused by Methicillin-Resistant Staphylococcus (e.g. S. Aureus and S. Epidermidis) and Penicillin-Resistant Pneumococci (Dökmeci, 2001; Young & Mangum, 2010). Dose restriction is required in case of a renal failure. It cannot be administered by oral route as it cannot be absorbed well enough. IM administration causes tissue necrosis. It is administered only by IV route in systemic infection treatments (Dökmeci, 2001).

*Dose:* IV infusion by syringe pump over 60 minute. Meningitis: 15 mg/kg per dose. Bacteremia: 10 mg/kg per dose (Young & Mangum, 2010). Newborn; IV, <7 days <1200g; 15 mg/kg/day every 24 hours, >1200g; 30-45 mg/kg/day every 12 hours, >7 days <1200g; 15 mg/kg/day every 24 hours, >7 days >1200g; 30-45 mg/kg/day every 8-12 hours. For others; 45-60 mg/kg/day every 6-8 hours (Dökmeci, 2001; Ekenel et al, 2001; Eroğlu, 2002).

*Adverse Effects:* Nephrotoxity and ototoxity: Enhanced by aminoglycoside therapy. Rash and hypotension (red man syndrome): Appears rapidly and resolves within minutes to hours. Lengthening infusion time usually eliminates risk for subsequently doses. Neutropenia: Reported after prolonged administration (more than 3 weeks). Phlebitis: May be minimized by slow infusion and dilution of the drug. (Eroğlu, 2002; (Young & Mangum, 2010).

*Preparation:* The maximum concentration should be 5 mg/ml.

*Miscible Serums*: 5% Dex, 10% Dex, SF

*Drugs to be confronted at the end point:* Dex/Amino acid mixture, Lipid solution, Acyclovir, Aminophylline, Ampicillin, Amicasin, Fluconazole, Heparin (concentration ≤1 U/ml), Calcium gluconate, Meropenem, Midazolom, Potassium chloride, Ranitidine, Sodium bicarbonate.

*Incompatibility:* Cefazolin, Cefepime, Cefotaxime, Ceftazidime, Ceftriaxone, Dekort, Heparin (concentration >1 U/ml)

*Storage Conditions:* The solution diluted with sterile water as 50 mg/ml can be stored for 14 days in refrigerator.

#### **6.1.7.5 Sulphonamide**

312 Complementary Pediatrics

Child; PO: 25-50 mg/kg/day every 8 hours, IM: 15-20 mg/kg/day every 8-12 hours, IV: 10-

It is a derivative of lincomycin. It inhibits protein synthesis. It is active against gram (+) cocci and anaerobes (Köksal & Reisli, 2002). Its metabolism in premature is highly variable

Newborn; (IM/IV), <7 days <2000g: 10 mg/kg/day every 12 hours >2000g: 15 mg/kg/day every 8 hours, >7 days <2000g: 15 mg/kg/day every 8 hours, >2000g: 20 mg/kg/day every 4 hours, infant and children; 10-25 mg/kg/day (PO) every 6-8 hours or 25-40 mg/kg/day

*Side effects:* Such gastrointestinal symptoms as nausea, vomiting, nuisance, and diarrhea are frequent (Apak, 1996; Eroğlu, 2002). Pseudomembranous enterocolitis may develop. Given fast by infusion it may cause syncope and respiratory arrest. Cleocin, Clindan, Klinoksin are

It inhibits protein synthesis. It has wide spectrum. It is bacteriostatic for many organisms in low concentrations. Newborn; <14 days 25 mg/kg/day PO, IV, every 12 hours >14 days <2000g: 25 mg/kg/day PO, IV, every 4 hours, >2000g: 50 mg/kg/day PO, IV every 4 hours, infant and children; 50-100 mg/kg/day PO, every 6 hours IV 100 mg/kg/day every 4 hours

*Side effects:* Non dose-related aplastic anemia is a rarely seen; but a serious complication. Dose-related bone marrow suppression is frequently seen and reversible (Eroğlu, 2002).

It is an antimicrobial and antibacterial agent. It is used with at least one more antituberculosis agent in tuberculosis treatment. And administered as single dose 10-20

*Uses:* Drug of choice for serious infections caused by Methicillin-Resistant Staphylococcus (e.g. S. Aureus and S. Epidermidis) and Penicillin-Resistant Pneumococci (Dökmeci, 2001; Young & Mangum, 2010). Dose restriction is required in case of a renal failure. It cannot be administered

It inhibits cell wall synthesis in gram (+) bacteria (Dökmeci, 2001).

*Dose*: 5-7.5 mg/kg/dose IV slow infusion for 30 min. or PO (Kanmaz, 2010).

PO: administered every 6 hours at a dose of 25-50 mg/kg/day (Köksal & Reisli, 2002).

*6.1.6.2.1 Chlortetracycline hydrochloride* 

**6.1.7 Other antimicrobial drugs** 

IV, IM every 6-8 hours (Eroğlu, 2002).

its derivatives (Eroğlu, 2002).

(Eroğlu, 2002; Dökmeci, 2001).

mg/kg/day PO (Dökmeci, 2001).

**6.1.7.3 Rifampicin** 

**6.1.7.4 Vancomycin** 

**6.1.7.2 Chloramphenicol** 

20 mg/kg/day every 12 hours (Eroğlu, 2002).

*6.1.6.2.2 Oxytetracycline* 

**6.1.7.1 Clindamycin** 

(Kanmaz, 2010).

The main indications are non-complicated urinary infections. Erythromycin-sulphonamide combination is effective in the treatment of otitis media. It is used in acute rheumatic fever prophylaxis. However it is not effective in group A streptococcus infection. Such drugrelated reactions as fever and rash may develop (Dökmeci, 2001).

#### **6.2 Antiviral drugs**
