Spectrum: Local Antimicrobial Stewardship, for Yangon Children's Hospital

Adolescent Second-Line 3

Second-Line Treatment

Abacavir (ABC) 8 mg/kg/dose, twice per day (max: 300mg/dose)

For age <16 years or weight <37.5kg

OR

Tenofovir (TDF) 8 mg/kg, once per day (max: 300mg/dose)

For > 2-12 years

AND

Lamivudine (3TC) twice per day (max: 150mg/dose)

  • Age <30 days: 2 mg/kg/dose

  • Age >30 days: 4 mg/kg/dose

  • Weight >50kg: 150 mg

OR

Emtricitabine (FTC) once per day (max: 200mg/dose)

  • Liquid: 6 mg/kg

  • Capsule: 200mg

AND

Atazanavir/Ritonavir co-formulation (ATV/r) once per day (max: 300mg/dose ATV + 100mg/dose RTV)

  • Preferred second-line regimen

  • 15-<25kg: 150mg ATV/80mg RTV

  • 25-<32kg: 200mg ATV/100mgRTV

  • 32-<39kg: 250mg ATV/100mg RTV

OR

Lopinavir/Ritonavir co-formulation (LPV/r) 230-350 mg/m², twice per day (max: 400mg/dose LPV + 100mg/dose RTV)

  • Preferred second-line regimen

  • Drug doses should be calculated according to body surface area

OR

Darunavir/Ritonavir co-formulation (DRV/r) 10-20 mg/kg, twice per day (max: 600mg/dose DRV + 100mg/dose RTV)

Alternative second-line regimen

OR

Dolutegravir (DTG) once per day (max: 50mg/dose)

  • Alternative second-line regimen

  • >30kg, <40kg: 35 mg/dose

  • ≥40kg: 50 mg/dose