GAS (S. pyogenes) pharyngitis

• BW ≤27 kg 300,000-600,000 u IM 1 dose

• BW >27 kg 900,000 u IM 1 dose

Congenital syphilis

• Age <2y 50,000 u/kg IM 1 dose

• Age ≥2y Refer to adult dose

Rheumatic fever prophylaxis

• BW ≤27 kg 600,000 u IM q4w

• BW >27 kg 1.2 mu IM q4w

Streptococcal or meningococcal pneumonia, endocarditis 150,000-300,000 u/kg IV #4-6

Pneumococcal or meningococcal meningitis 250,000 u/kg IV #6 x7-14d (max 12-20 mu/d)

Gonococcal arthritis 100,000 u/kg IV #6 x7-10d

Gonococcal meningitis 250,000 u/kg IV #6 x10-14d

Gonococcal endocarditis 250,000 u/kg IV #6 x4w

Congenital syphilis, neurosyphilis 200,000-300,000 u/kg IV #4-6 x10-14d

Diphtheria 150,000-250,000 u/kg IV #4 x7-10d

Rat-bite fever 150,000-250,000 u/kg IV #6 x4w

If BW ≥45 kg & gonococcal arthritis, meningitis, endocarditis, refer to adult dose