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Extra info for Clinical Guidelines Diagnosis and treatment manual for curative programmes in hospitals and dispensaries
Azithromycin treatment has the advantage of being short. erythromycin PO for 10 days Children: 30 to 50 mg/kg/day in 2 to 3 divided doses Adults: 2 to 3 g/day in 2 to 3 divided doses or azithromycin PO for 3 days Children: 20 mg/kg once daily Adults: 500 mg once daily – Gonococcal or syphilitic pharyngitis: same treatment as for genital gonorrhoea and syphilis – Diphtherial pharyngitis: see diphtheria, page 55 – Vincent tonsillitis: penicillin V or erythromycin as above – Peritonsillar abscess: refer for surgical drainage 54 2.
Chronic and persistent diarrhoea does not require rapid rehydration. The rehydration protocol differs from that used in non-malnourished: • In the absence of hypovolaemic shock, rehydration is conducted by the oral route (if necessary by nasogastric tube), using specific oral rehydration solutions 6 ( ReSoMal ), containing less sodium and more potassium than standard solutions. R e S o M a l i s a d m i n i s t e re d u n d e r s t r i c t m e d i c a l s u p e r v i s i o n ( c l i n i c a l evaluation and weight every hour).
Monitor the weight of the child during the course of the illness, and consider food supplements for several weeks after recovery. – Antibiotic therapy: Antibiotic treatment is indicated in the first 3 weeks after onset of cough. Infectivity is virtually nil after 5 days of antibiotic treatment. Alernative First line Antibiotic azithromycin PO once daily, for 5 days erythromycin PO in 3 divided doses, for 7 days cotrimoxazole PO in 2 divided doses, for 14 days Child Adult 0-5 months: D1 500 mg 10 mg/kg/day D2-D5 250 mg/day ≥ 6 months: D1 10 mg/kg (max 500 mg) D2-D5 5 mg/kg/d (max 250 mg/d) 50 mg/kg/day (avoid in infant < 1 month of age) 1 g/day 40 mg/kg/day SMX 1600 mg/day SMX + 8 mg/kg/day TMP + 320 mg/day TMP (avoid in infant < 1 month of age, and last month of pregnancy) – For hospitalised children: • Place the child in a semi-reclining position (± 30°).