Spectrum: Local Antimicrobial Stewardship, for IWK Health Centre

Atrioventricular heart block or carditis

Infection Prevention and Control

Routine Practices

Consult Infectious Diseases

Most Likely Pathogen

Borellia burgdorferi

Duration of Therapy

14 - 21 days

Suggested Regimen

For patients greater than 8 years of age

Doxycycline 2.2 mg/kg/dose PO BID
Round dose to nearest 25 mg (1/4 tablet)
Maximum: 100 mg/dose

For patients less than 8 years of age:

Amoxicillin 16 mg/kg/dose PO TID
Maximum: 500 mg/dose

OR If IV Therapy Required

Ceftriaxone 50-75 mg/kg/dose IV q24h
Maximum: 2000 mg /dose

Once patient is stabilized without ongoing symptoms or signs, can be switched to oral therapy as above to finish 14 - 21 days

IgE mediated Penicillin Allergy

Cefuroxime 15 mg/kg/dose PO BID
Maximum: 500 mg /dose

OR

Ceftriaxone 50-75 mg/kg/dose IV q24h
Maximum: 2000 mg /dose

Once patient is stabilized without ongoing symptoms or signs, can be switched to oral therapy as above to finish 14 - 21 days