Pediatric Dosage of Ornidazole and Ofloxacin
For pediatric patients, the recommended dosage of ornidazole is 20-30 mg/kg as a single daily dose, while ofloxacin should be administered at 7.5 mg/kg every 12 hours (maximum 400 mg/dose). 1, 2
Ornidazole Dosing
Recommended Dosage
- Single-dose treatment: 20-30 mg/kg as a single dose has shown 94-97% efficacy in treating protozoal infections like giardiasis in children 2
- Multi-day treatment: 25 mg/kg/day divided into two doses for 5 days is also effective for protozoal infections 2
Age-Based Considerations
- Suitable for children 2-15 years of age 2
- Safety and efficacy data in infants under 2 years is limited
Clinical Efficacy
- Single-dose ornidazole (20-30 mg/kg) has demonstrated excellent efficacy against protozoal infections with eradication rates of 94-97% 2
- This regimen shows superior efficacy compared to standard metronidazole treatment (89% efficacy) 2
Ofloxacin Dosing
Recommended Dosage
- Oral/IV: 7.5 mg/kg every 12 hours (maximum 400 mg/dose) 1
- For specific infections like plague prophylaxis, this dosage has been established as an alternative treatment option 1
Age-Based Considerations
- Generally used in children ≥1 month to ≤17 years 1
- Fluoroquinolones including ofloxacin should be used with caution in young children due to potential effects on cartilage development 1
- Data on use in infants is limited 3
Important Pharmacokinetic Considerations
- Current recommended pediatric dosage (15-20 mg/kg/day) may result in lower drug exposure compared to adults 3
- Mean AUC0-24 in children receiving 20 mg/kg was 66.7 μg·h/ml, which is below the adult target exposure of 103 μg·h/ml after standard 800-mg dose 3
- Body weight significantly affects drug exposure, with AUC0-24 increasing by 1.46 μg·h/ml for each 1-kg increase in body weight 3
Safety Considerations
Ornidazole
- Generally well-tolerated in pediatric populations 2
- No significant adverse effects reported in clinical studies using the recommended dosages 2
Ofloxacin
- Fluoroquinolones carry risk of permanent tooth discoloration and tooth enamel hypoplasia in young children 1
- Should be used only when benefits outweigh risks 1
- No grade 3 or 4 adverse events attributed to ofloxacin were observed in pediatric MDR-TB studies 3
- Ofloxacin suspension for oral liquid administration is not available in the United States 1
Combination Therapy
- Fixed-dose combination of ofloxacin with ornidazole has shown efficacy in treating diarrhea and dysentery in adults 4
- For pediatric patients, individual dosing of each medication based on weight is recommended to ensure optimal therapeutic effect 2, 3