Ofloxacin Dosing for Pediatric Patients
For pediatric patients, ofloxacin should be administered at 7.5 mg/kg every 12 hours (maximum 400 mg/dose). 1
General Dosing Guidelines
- Ofloxacin is generally used in children ≥1 month to ≤17 years, with caution due to potential effects on cartilage development 1
- For standard infections, the recommended dosage is 7.5 mg/kg every 12 hours, not exceeding 400 mg per dose 1
- For tuberculosis treatment in children, ofloxacin can be administered at 15-20 mg/kg/day (maximum 1.0 g/day) as a single daily dose or divided into two doses 1
Age-Specific Considerations
- For children younger than 5 years of age, fluoroquinolones like ofloxacin may require more frequent dosing due to faster clearance compared to adults 2
- Studies have shown that children younger than 5 years clear fluoroquinolones nearly twice as fast as adults, resulting in approximately half the systemic exposure 2
- For multidrug-resistant tuberculosis treatment, the current pediatric dosage of 15-20 mg/kg may result in lower drug exposures compared to adults 3
Administration Considerations
- Ofloxacin suspension for oral liquid administration is not available in the United States 1, 4
- For otitis externa in children, topical ofloxacin otic 0.3% solution has been used at a dose of 5 drops once daily for 7 days in children aged 6 months to <13 years 5
Safety Considerations
- Fluoroquinolones, including ofloxacin, should be used with caution in young children due to potential effects on cartilage development 1
- Despite concerns, studies have shown ofloxacin to be safe and well-tolerated in children with multidrug-resistant tuberculosis 3
- No grade 3 or 4 adverse events attributed to ofloxacin were observed in pediatric studies 3
- Regular monitoring for potential adverse effects, particularly with prolonged use of fluoroquinolones, is recommended 1
Clinical Efficacy
- In comparative studies for typhoid fever treatment, ofloxacin at 10 mg/kg/day in two divided doses for 5 days showed superior efficacy compared to cefixime 6
- For multidrug-resistant tuberculosis, current dosing may need to be optimized as studies show exposures in children are well below reported adult values 3