NHS Greater Glasgow & Clyde Area Drug and Therapeutics Committee
Greater Glasgow and Clyde Medicines
Medicines Update

Paediatric Infection Guidelines

The primary care infection management guidelines for children have recently been updated. The guidelines aim to provide a simple empirical approach to treatment of common childhood infections, while promoting the safe, effective and economic use of antibiotics and minimising the emergence of bacterial resistance. Changes are:


  • Clarithromycin is the macrolide of choice where indicated as a penicillin alternative. Erythromycin has been removed. Clarithromycin is administered twice daily, not four times daily, and is better tolerated.
  • Note that clarithromycin is also associated with clinically significant drug interactions and may prolong QTc interval
  • For uncomplicated lower urinary tract infections, trimethoprim remains the treatment of choice for children over six months of age. 
  • If a child is currently on trimethoprim prophylaxis, has had previous trimethoprim resistance or has known renal abnormalities, co-amoxiclav is recommended (nitrofurantoin for those with penicillin allergy)


If microbiological advice is required, please contact either the Microbiology Department at your local hospital or the Paediatric Antimicrobial Pharmacist or Paediatric Infectious Diseases service at the Royal Hospital for Children.