Table 2 Pediatric drug doses of used medications

Azithromycin

10 mg/kg once on day 1 (maximum dose: 500 mg/dose) , followed by 5 mg/kg (maximum dose: 250 mg/dose) once daily on days 2 to 5

• Monitor ECG in high risk patients due to the risk of QTc prolongation.

• For 5 days

Ceftriaxone

100 mg/kg/dose once daily (maximum daily dose: 2gm mg/day)

• For 5-10 days

Ribavirine

children> 3 years of age: 15 mg/kg /day in 2 divided oral doses

• Patients with impaired renal function, adjust ribavirine dose according to nephrologist advice.

• Monitor CBC, serum creatinine, liver function

• For 14 days

Lopinavir/ Ritonavir

Dosage based on weight, presented based on mg of lopinavir; maximum dose: Lopinavir 400 mg/ritonavir 100 mg 7–15 kg: 12 mg/kg twice daily 15–40 kg: 10 mg/kg twice daily >40 kg: 400 mg/100 mg twice daily

• Do not use lopinavir/ ritonavir in pre-term or full term neonates before 14 days of age.

• Check for drug-drug interaction (consult clinical pharmacist).

• If lopinavir/ritonavir is not available may consider darunavir/cobicistat as an alternative.

• For 14 days

Hydroxychloroquine

6.5 mg/kg orally every 12 hours (max: 600 mg/dose) for two doses, followed by 3 mg/kg orally every 12 hours (max: 200 mg/dose) for a total of 5-10 days

• Check contraindications carefully

Contraindication :

• Use with caution in QT interval prolongation

Allergy to 4-aminoquinoline

• Pediatric dose may change based on future studies

Chronic liver and kidney disease or Hematological Disorders

• For 5-10 days

Patients with arrhythmia and chronic heart disease

Patients known to have retinal disease or hearing loss

Skin disorders (including rash, dermatitis, and psoriasis)

Glucose-6-phosphate dehydrogenase (G6PD) deficiency

Revise drug drug interaction carefully with pharmacist

Piperacillin/Tazobactam

300 mg/ kg/day divided every 6-8 hours

• For 5-10 days but may be extended on a case-bycase basis

Vancomycin

15 mg/kg/dose every 6 hours

• For 5-10 days but may be extended on a case-bycase basis

Tocilizumab

<30 kg: 12 mg/kg

• H score with a value more than 169

≥30 kg: 8 mg/kg (max: 800 mg/dose)

• Duration: One dose

• Response usually seen at 48-72h

• Don't exceed 800 mg/dose

Methylprednisolone

2 mg/kg/day

• For 3-5 days when Tocilizumab not available