**6.1.6.1 Erythromycin**

It inhibits the protein synthesis by binding to ribosome. It can be used with sulphonamide for otitis media treatment (Eroğlu, 2002; Gallardo & Thomas, 1999).

Uses: Erythromycin is used alternatively instead of penicillin to treat bacterial infections, especially in patients allergic to penicillin. The drug is effective in the treatment of diphtheria treatment of whooping cough, pneumonia caused by Mycoplasma pneumonia (including infants), Legionnaires' disease, the treatment of Chlamydia, Gonorrhea, Syphilis, endocarditis, urinary tract inflammation, conjunctivitis (Young & Mangum, 2010).

Dose: 10 mg/kg PO (Young & Mangum, 2010). While erythromycin estolate should be administered every 3 hours; ethylsuccinate one should be administered every 6 hours with food. In chlamydia treatments: Estolate form 12.5 mg/kg/dose every 6 hours for 14 days. In serious infections 5-10 mg/kg/dose every 6 hours with a slow infusion for 60 min. or 10 mg/kg/dose PO. In ophthalmia neonatorum treatment: 0.5% cream for each conjunctiva (Kanmaz, 2010).

*Side effects:* It is accepted as one of the most dependable antibiotics. The side effects are rarely seen and usually light and limited to skin. However in several occasions angioedema and urticarial have been observed to develop (Gallardo & Thomas, 1999).

*Drug Interaction:* The plasma clearance of midazolam decreases by 50%. Theophylline and carbamazepine serum concentration may increase. When used together with sisapride, it causes serious dysrhythmias (Kanmaz, 2010).

*Monitor:* Heart rate and blood level should be monitored during IV use. Liver function tests should be carried out. Hemogram can be used for eosinophilia (Kanmaz, 2010).

#### **6.1.6.2 tetracyclines**

It inhibits bacteria protein synthesis. It has wide-spectrums active against gram (+) and gram (-) bacteria (Behrman & Kliegman, 2001; Eroğlu, 2002). Its use is limited in infants and children because of the side effects. Tetracycline prevents growth accumulating in bones and teeth. It should be used on ones older than 8 years old. It may increase intracranial pressure in infants (Eroğlu, 2002).

The Administration and Dose of Most Frequently Used Drugs in Pediatrics 313

by oral route as it cannot be absorbed well enough. IM administration causes tissue necrosis. It

*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;

*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

*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

*Incompatibility:* Cefazolin, Cefepime, Cefotaxime, Ceftazidime, Ceftriaxone, Dekort, Heparin

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

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 drug-

Acyclovir is one of the most commonly used antiviral drugs (Kavakl et al, 1998). Treatment of neonatal herpes simplex infections varicella zoster infections with CNS and pulmonary involvement, and herpes simplex encephalitis (Kavakl et al, 1998; Young & Mangum, 2010). It can be used for the treatment of herpes simplex virus infections of newborn, varicella infections of children taking immunosuppressive and of immunodeficient children (Kavakl

*Dose:* 20 mg/kg per dose Q8 hours IV by syringe pump over 1 hour. Prolong the dosing interval in prematures infant <34 weeks PMA, or in patients with significant renal impairment or hepatic failure. Treat localized herpes simplex infections for 14 days,

is administered only by IV route in systemic infection treatments (Dökmeci, 2001).

45-60 mg/kg/day every 6-8 hours (Dökmeci, 2001; Ekenel et al, 2001; Eroğlu, 2002).

by slow infusion and dilution of the drug. (Eroğlu, 2002; (Young & Mangum, 2010).

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

related reactions as fever and rash may develop (Dökmeci, 2001).

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

bicarbonate.

(concentration >1 U/ml)

days in refrigerator. **6.1.7.5 Sulphonamide** 

**6.2 Antiviral drugs 6.2.1 Acyclovir** 

et al, 1998).
