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Treatment: Antibiotics
| Country | Oral antibiotic for | IM pre-referral antibiotic for | ||||||
|---|---|---|---|---|---|---|---|---|
| Pneumonia Ear infection | Dysentery | Cholera | Young infant | Older child | ||||
| 1st line | 2nd line | 1st line | 2nd line | 1st line | 2nd line | |||
| Afghanistan | COT | AMO | COT | NA | COT | ERY | GEN+PEN | CHL |
| Djibouti | COT | AMO | COT | AMO | ERY | COT | GEN+PEN | THL or AMP |
| Egypt | AMO | COT | COT | NA | COT | ERY | GEN+PEN | CHL |
| Iran (Islamic Republic of) | AMO | COT | (referred) | -- | COT | -- | GEN+AMP | CHL |
| Iraq | AMO | COT | MET | -- | TET | ERY | CEFX or AMP+GEN |
CEFX |
| Morocco | COT | AMO | COT | AMO | COT | ERY | GEN+PEN | THL or AMP |
| Occupied Palestinian territory | AMO | COT | COT | NA | COT | ERY | GEN+PEN | CHL |
| Oman | AMO | + CLA | NA | CEP | -- | -- | CEFX | CEFX |
| Pakistan | AMO | CEP | CIP | MET§ | CIP | -- | AMP+GEN | AMP+GEN |
| Syrian Arab Republic | AMO | COT | COT | NA | -- | -- | GEN+AMP | AMP |
| Sudan | COT | AMO | COT | NA | TET | COT | GEN+PEN | CHL |
| Tunisia | AMO | -- | ? | ? | -- | -- | -- | -- |
| Yemen | AMO | COT | COT | NA | COT | ERY | GEN+AMP | CHL |
AMO = Amoxicillin; AMP = Ampicillin +CLA = Amoxicillin+cluvanic acid; CEP = Cephradine or cephalexine; CEFX = Ceftriaxone; CHL = Chloramphenicol; CIP = Ciprofloxacin; COT = Cotrimoxazole; ERY = Erythromycin; GEN = Gentamicin; MET = Metronidazole; NA = Nalidixic acid; PEN = Benzyl penicillin; TET = Tetracycline THL = Thiamphenicol;
§(add if no improvement upon follow-up)
Treatment: Antimalarials and other drugs
| Country | Antimalarial | Convulsions | Streptococcal sore throat | Deworming | ||
|---|---|---|---|---|---|---|
| Oral | IM-Preferral | |||||
| Afghanistan | CHQ | SP | QUI | DIA | MEB* | |
| Djibouti | CHQ | SP | QUI | DIA or MED | PEN V or AMO# | MEB* |
| Egypt | -- | -- | -- | SV | BP | -- |
| Iran (Islamic Republic of) | (physicians only) | (physicians only) | PEN V | -- | ||
| Iraq | CHQ Pyrimethamine^ | SP" | -- | DIA | BP or AMO (ERY)# | -- |
| Morocco | -- | -- | -- | DIA or MED | AMO or PEN V, BP (ERY)# | -- |
| Occupied Palestinian territory | -- | -- | -- | DIA | BP (ERY)# | -- |
| Oman | (Hospital management only) | -- | PEN V | -- | ||
| Pakistan | ACTo | -- | QUI | DIA | BP or AMO | MEB |
| Syrian Arab Republic | -- | -- | -- | SV | BP (ERY)# | -- |
| Sudan | ACTo | ACTo | QUI | DIA | -- | -- |
| Tunisia | -- | -- | -- | DIA | BP or AMO, PEN V (ERY) | -- |
| Yemen | ACTo | ACTo | ART sup or QUI | DIA | PEN V or BP | MEB* |
IM=intramuscular; ACT = Artemisinin-base Combination Therapy; AMO = Amoxicillin; ARTsup = Artesunate suppositories; BP = Benzathine-penicillin; CHQ = Chloroquine; DIA = Diazepam; MEB = Mebendazole; MED = Medazolam; PEN V = Penicillin V (Erythromycin if allergic to penicillin); PP = Pyrantel pamoate; QUI = Quinine; SP = Sulfadoxine-pyrimethamine; SV = Sodium valproate;
#STREPTOCOCCAL SORE THROAT
Djibouti: AMO for children 2 up to 12 months old, PEN V for older children; ERY for those allergic to penicillin.
Iraq: If BP not available, AMO given for 10 days; ERY for those allergic to penicillin
Morocco: AMO for children less than 2 years old, PEN V for those 24 up to 36 months old, BP for older children; ERY for those allergic to penicillin.
Occupied Palestinian territory, Syrian Arab Republic, Tunisia: ERY for children allergic to penicillin.
" SULFADOXINE-PYRIMETHAMINE
Iraq: Not to be given to children less than 2 years old
* MEBENDAZOLE:
Afghanistan: Child 1 year old or older and no dose in the previous 6 months: 250mg if child 2 yr
Djibouti: If Ancylostomiasis and Oxyuriasis are endemic in the Region, child is 2 years old or older, and no dose in the previous 6 months: 500mg
Pakistan: Child 1 year old or older and no dose in the previous 6 months: 500mg
Yemen: Child 2 years old or older and no dose in the previous 6 months: 500mg
^ PYRIMETHAMINE:
Iraq: To be given following chloroquine in all children more than 1 year of age, except for children with G-6-PD or specific contra-indication
Sulfadoxine-pyrimethamine (SP) not to be given to children less than 2 years old
oACT (Artemisinin-base Combination Therapy ):
Pakistan ACT includes first-line treatment with artesunate + sulfadoxine-pyrimethamine (SP)
Sudan, Yemen: ACT specifically includes:
a) First-line treatment: Artesunate + sulfadoxine-pyrimethamine (SP);
b) Second-line treatment: Artemether + lumefantrine
Prevention: Vitamin A and vitamin D supplementation
Afghanistan (vitamin A)
Doses of vitamin A administered if child is 6 months old or older and has received no vitamin A in the previous 6 months:
< 1 yr: 100 000 IU
≥ 1 yr: 200 000 IU
Djibouti (vitamin A)
Doses of vitamin A administered:
At 6 months: 100 000 IU
At 12 months: 200 000 IU
At 18 months: 200 000 IU
Egypt (vitamin A)
Doses of vitamin A administered:
At 9 months: 100 000 IU
At 18 months: 200 000 IU
Iran (Islamic Republic of) (vitamin A and D)
Daily vitamin A (1500 IU) and vitamin D (400 IU), to be administered from age 15 days up to 2 years.
Iraq (vitamin A and D)
Vitamin A and D administered daily to children at 4-6 months up to 9 months
Vitamin D drops: daily to children at 4-9 months
Doses of vitamin A administered;
At 9 months: 50,000 IU with measles vaccine.
At 18 months: 100,000 IU with booster dose of DPT and polio
Morocco (vitamin A and D)
Doses of vitamin A administered:
At 6 months: 100 000 IU
At 12 months: 200 000 IU
At 18 months: 200 000 IU
Doses of vitamin D administered:
At birth: 600 000 IU
At 6 months: 600 000 IU
Occupied Palestinian territory (vitamin A and D)
Vitamin A (500 IU) and D (200 IU) drops
Oman (vitamin A)
Doses of vitamin A administered at 7 and 18 months
Pakistan (vitamin A)
Doses of vita¬min A administered if child is 6 months old or older and has received no vitamin A in the previous 6 months:
< 1 yr: 100 000 IU
≥ 1 yr: 200 000 IU
Sudan (vitamin A)
Doses of vita¬min A administered if child is 6 months old or older and has received no vitamin A in the previous 6 months:
< 1 yr: 100 000 IU
≥ 1 yr: 200 000 IU
Syrian Arab Republic (vitamin A)
Dose of vitamin A (200 000 IU) administered at 12 months with MMR immunization
Tunisia (vitamin D)
Doses of vitamin D (200 000 UI) adminis¬tered at 15 days, 6 months, 1 year, 18 months, and thereafter every winter until age 5
Yemen (vitamin A)
Dose of vitamin A (100 000 IU) administered at 9 months and (200 000) at 18 months
