1. Clarithromycin 250 mg/5ml suspension( Wx 0.15)x2x10
2. Voltaren25mg suppositories  + Paracetamol ( Revanin) 250mg/5ml Syrup (w/4) alternately every 6 hours  until fever subside

Clarithromycin

Otitis Media

• <6 months: Safety and efficacy not established
• ≥6 months: 15 mg/kg/day PO divided q12hr for 10 days; not to exceed 500 mg/dose

Community-Acquired Pneumonia

• <3 months: Safety and efficacy not established 
• ≥3 months: 15 mg/kg/day PO divided q12hr for 10 days; not to exceed 500 mg/dose 

Sinusitis

• <6 months: Safety and efficacy not established
• ≥6 months: 15 mg/kg/day PO divided q12hr for 10 days; not to exceed 500 mg/dose

Bronchitis

• <6 months: Safety and efficacy not established
• ≥6 months: 15 mg/kg/day PO divided q12hr for 10 days; not to exceed 500 mg/dose

Skin Infections

• <6 months: Safety and efficacy not established
• ≥6 months: 15 mg/kg/day PO divided q12hr for 10 days; not to exceed 250 mg/dose

Streptococcal Pharyngitis

• <6 months: Safety and efficacy not established
• ≥6 months: 7.5 mg/kg q12hr for 10 days; individual dose not to exceed 250 mg

Endocarditis (Off-label)

• 15 mg/kg PO 30-60 minutes before procedure; individual dose not to exceed 500 mg     

Pertussis (Off-label)

• <1 month: Safety and efficacy not established
• 1-6 months: 7.5 mg/kg/dose PO q12hr for 7 days

>6 months: 7.5 mg/kg/dose PO q12hr for 7 days

Paractamol

• Analgesic and antipyretics
• Not anti-inflammatory effect
• Suitable for Temperature between (37.5C – 38.5C)
• Safe under 6 months

Trade names  : ( Revanin ,Adol,Panda,Dolocet ,Feverol, panadol )

Concentrations: 500 mg tablet, ,1g tablet ,125 mg/5 ml syrup, 250 mg/5 ml syrup, 125 mg suppositories, 250 mg suppositories, 1g/100ml solution for infusion

Dose : 

Tablet, capsule : 

• 500mg tabs 1-2 tabs /cap every 6 hours

Syrup, suspension :

• < 5year  : 125mg/5ml susp (w/2) Every 4 – 6 hours
• 5-12 year : 250mg/5ml susp (w/4) Every 4 – 6 hours 

Suppositories :

• <1Y : 125 mg supp Every 8 hours  (1 supp x 3 )
• >1Y : 250mg supp Every 8 hours ( 1supp x 3 )

Iv solution 1g/100ml :

• <10kg : 0 .75ml/kg 
• >10kg , <50kg :  1.5ml/kg
• >50kg : 100ml Slowly over 15 minute

Maximum dose : 4g daily 

Pregnancy and lactation : Paracetamol is the first choice of painkiller in pregnancy and breastfeeding

Diclofenac sodium

• Mainly analgesic
• Has anti-inflammatory effect
• Suitable for temperature >39
• Contraindicated in < 1year age
• After meal

Trade names  of diclofenac  : (Diclogesic, Votrex, Infla-ban, Voltaren, Tratul, Rofenac Diclofen, Olfen,Optifen, Almiral, Clofen, Diclosal, Divido, Diclomax, Nalgofen, Difen,)

Other concentrations: 12.5 mg, 50, 100 suppositories, 25, 50, 100 tablet, 100 capsules, 75 mg/3ml mg injection

Dose : 

Tablet: 

• 75 mg to 150 mg daily in two or three divided doses. 

Suppositories :

Adults: 75-150mg daily, in divided doses every 12 hour

children:

• 1-3 years or <15 kg: 12.5 mg suppositories every 12 hour
• 3-12years or >15kg : 25mg suppositories every 12 hour

IM Injection 75mg/3ml

Adults :  25 to 75 mg depending on the severity pain. 

The maximum daily dose is :150 mg.

Contraindication: 

• History of hypersensitivity to diclofenac sodium
• Asthma 
• Hypertension
• current or recent stomach ulcer
• severe heart failure.or evere liver disease

Pregnancy : not usually recommended in pregnancy