Metronidazole Dosing in Pediatric Patients
Dosing Guidelines by Clinical Scenario
- The Infectious Diseases Society of America recommends metronidazole dosing at 7.5 mg/kg/dose three or four times daily (maximum 500 mg per dose) for non-severe infections in pediatric patients 1, 2
- For initial episodes or first recurrence of non-severe Clostridium difficile infection (CDI), metronidazole is recommended at 7.5 mg/kg/dose three or four times daily for 10 days (maximum 500 mg per dose) 3, 4
- For severe or fulminant CDI, oral vancomycin is recommended over metronidazole (strong recommendation, moderate quality of evidence) 6
- If metronidazole is used in severe infections, it is recommended at 10 mg/kg/dose three times daily intravenously (maximum 500 mg per dose) 7
- For first recurrence of non-severe CDI, the same dosing as the initial episode is recommended (7.5 mg/kg/dose three or four times daily) 8
- For second or subsequent recurrences, oral vancomycin is recommended over metronidazole (weak recommendation, low quality of evidence) 9