Recommended Dosage of Ofloxacin in Children
The recommended dose of ofloxacin in children is 7.5 mg/kg every 12 hours orally, with a maximum dose of 400 mg per dose. 1
Dosing Guidelines by Administration Route
Oral Administration
- Dosage: 7.5 mg/kg every 12 hours
- Maximum dose: 400 mg per dose
- Note: Ofloxacin oral suspension is not commercially available in the United States
For Specific Conditions
Treatment of Pneumonic or Septicemic Plague
- Ofloxacin is considered an alternative (not first-line) treatment
- Dosage: 7.5 mg/kg every 12 hours orally
- Maximum dose: 400 mg per dose
- Duration: 10-14 days of treatment is recommended
Pre- and Post-exposure Prophylaxis
- For children exposed to Yersinia pestis
- Dosage: 7.5 mg/kg every 12 hours orally
- Maximum dose: 400 mg per dose
- Duration: 7 days for post-exposure prophylaxis
Important Clinical Considerations
Age and Weight Considerations
- Ofloxacin is generally not a first-line antibiotic for most pediatric infections
- Fluoroquinolones like ofloxacin should be used with caution in children due to potential adverse effects on developing cartilage
Pharmacokinetic Considerations
- Studies show that children may have faster clearance of fluoroquinolones compared to adults
- Research with ofloxacin in children with drug-resistant tuberculosis showed that a 20 mg/kg dose resulted in exposures well below reported adult values, suggesting potential need for dosage adjustment in certain conditions 2
Safety Profile
- Fluoroquinolones should be used cautiously in children due to potential effects on cartilage development
- When used topically (as 0.3% otic solution) for ear infections, ofloxacin has shown good safety profile in children 3, 4
- The most common adverse events with topical use are bitter taste (5%) and pruritus (2%) 3
Monitoring
- Monitor for potential adverse effects including:
- Gastrointestinal symptoms
- Rash
- Joint pain
- Tendon pain or inflammation
Special Considerations
Off-Label Use
- Ofloxacin is often used off-label in children, as fluoroquinolones have historically had limited approval for pediatric use
- The benefit-risk assessment should strongly favor use before prescribing
Alternative Antibiotics
- For most pediatric infections, other antibiotics are preferred as first-line agents
- Consider alternatives based on the specific infection, local resistance patterns, and patient factors
Formulation Challenges
- Ofloxacin suspension for oral liquid administration is not available in the United States 1
- This may present challenges for administration to young children who cannot swallow tablets
Practical Application
- When prescribing ofloxacin for children, calculate the dose based on actual body weight
- Ensure the dose does not exceed the maximum recommended dose of 400 mg per dose
- Consider consulting with a pediatric infectious disease specialist when using fluoroquinolones in children, particularly for serious infections