Skip to main content

Alternative Therapies for Severe Cephalosporin Allergies

Trimethoprim-sulfamethoxazole: Cystitis or Pyelonephritis: 6-12 mg TMP/kg/day PO (max: 160 mg TMP/dose).

OR

Ciprofloxacin:

    • Cystitis:
      • Oral: Immediate release tablet or oral suspension: 20 – 40 mg/kg/day divided q12h (max: 500 mg/dose).
      • IV: 20 mg/kg/day divided q12h (max: 400 mg/dose).
    • Pyelonephritis:
      • Oral: Immediate release tablet or oral suspension: 20 – 40 mg/kg/day divided q12h (max: 750 mg/dose).
      • IV: 30 mg/kg/day divided q8h (max: 400 mg/dose).

OR (if cystitis alone)

Nitrofurantoin:

    • Macrocrystal 5-7 mg/kg/day PO divided q6h (max: 100 mg/dose).

OR

    • FOR ADOLESCENTS ONLY: Macrocrystal/monohydrate 200 mg PO divided BID.

These pathways do not establish a standard of care to be followed in every case. It is recognized that each case is different, and those individuals involved in providing health care are expected to use their judgment in determining what is in the best interests of the patient based on the circumstances existing at the time. It is impossible to anticipate all possible situations that may exist and to prepare a pathway for each. Accordingly, these pathways should guide care with the understanding that departures from them may be required at times.

Evidence Based Practice Menu
Children's Mercy Kansas City   /    Health Care Providers   /    Evidence Based Practice / Clinical Pathways    /    Clinical Practice Guidelines, Care Process Models, and Enhanced Recovery After Surgery Pathways   /    Urinary Tract Infection (UTI)   /   Alternative Therapies for Severe Cephalosporin Allergies