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Pediatric Terrorism and Disaster Preparedness

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Table 4.6. Treatment Recommendations for Tularemia in Children Before Test Results Are Known

Drug Dosage
Preferred choices
Streptomycin 15 mg/kg, IM, BID 10 days (should not exceed 2 gram/day)
Gentamicin 2.5 mg/kg, IM or IV, TID 10 days (not an FDA-approved use)
Alternative choices
Doxycyclinea If weight ≥45 kg, 100 mg, IV 14-21 days
If weight <45 kg, give 2.2 mg/kg, IV, BID 14-21 days
Chloramphenicola 15 mg/kg, IV, 4 times daily 14-21 days (not an FDA-approved use)
Ciprofloxacina 15 mg/kg, IV, BID 10 days (should not exceed 1 gram/day)

Notes: BID = twice a day; TID = three times a day; PO = by mouth; IV = intravenous; IM = intramuscular; FDA = Food and Drug Administration.

a Treatment with doxycycline, chloramphenicol, or ciprofloxacin given IM or IV can be switched to oral administration when clinically indicated.

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