1.

Childhood Immunization Schedule 2014

Vaccines given in the Philippines Expanded Program of Immunization (PEPI) of
the Department of Health include:
BCG
MMR
DTwP-Hib-HepB
Rotavirus
OPV
PCV
Measles
Td

Vacc
ine

Mini
mum
Age

D
o
s
e

R
o
u
t
e

BCG

At
birth;
prefe
rably
within
the
first 2
mont
hs of
life

0
.
0
5
m
l
f
o
r
N
B
0
.
1
m
l
f
o
r
ol
d
e
r
in
f
a
n
t
0
.
5
m
l
0
.
5
m

I
D

I
M

4
wee
ks

4
wee
ks

DTP

6
week
s

Hep
atiti
sB

At
birth

Inte
rval
bet
wee
n
dos
es

Annotati
ons

Monoval
ent is
given at
birth then

HiB

OPV

Mea
sles

6
week
s
6
week
s

9
mont
hs

MM
R

12
mont
hs

Rota
viru
s
PCV

6
week
s
6
week
s

subsequ
ent
doses
are given
at
6,10,14
weeks of
age as
combinat
ion
vaccines
containin
g DTwPHeb BHib

0
.
5
2
d
r
o
p
s
0
.
5
m
l

I
M

P
O

S
C

0
.
5
m
l

S
C

4
wee
ks

P
O

I
M

4
wee
ks
4
wee
ks

0
.
5
m
l

4
wee
ks
4
wee
ks

Can be
given as
early as
6 months
in cases
of
outbreak
Second
dose is
administ
ered at
ages 4-6
years old

Booster
6 months
after the
3rd dose

Td

Preg
nant
adole
scent
s

0
.
5
m
l

2. Dengue blot interpretation

Primary dengue
infection
NS1

A glycoprotein essential
antigen
s
for viral replication and viability

I
M

1
mon
th
then
6-12
mon
ths

Secondary dengue
infection

Similar response to
primary infection

Appears from Day 1 after

onset of fever and up to Day 6

Circulate at high levels in

serum during the entire clinical
illness and in the first fever
days of convalescence

Not detectable once anti

NS1 IgB Ab are produced
(corresponds to
defervenscence)

IgM
antibod
ies

Produced approximately
5 days after symptoms
appears
Rise for 1-3 weeks, may
persist up to 60 days
May be detectable for up
to 6 months

Kinetics of IgM response

is variable
20-30% of patients do not
produce IgM Ab by day 10,
may not be detected until
20 days after onset of
infection, same false
negative results are

observed

IgG
antibod
ies

Appear approximately 14
days after onset of
symptoms
Persist for life

May be produced as low

or undetectable levels for
a shorter period than in a
primary infection
Rise rapidly 1-2 days after
onset of symptoms
Reach levels above those
found in primary or past
infection
Persist at high levels for
30-40 days then decline to
levels found in primary or
past infection

3. Diagnostic criteria for SLE

MNEMONICS: SOAP BRAIN MD

Serositis such pleuritis or pericarditis

Oral ulcers
Arthritis (usually oligo or polyarticular)
Photosensitivity

Blood disorders: namely hemolytic anemia, leukopenia, lymphopenia, and

thrombocytopenia
Renal involvement with nephrotic picture
Anti nuclear antibodies in 95% of patients

Immunologic abnormalities such as Anti-Sm, Anti-dsDNA, Antiphospholipid, positive syphilis serology

Neurologic: mainly seizure and psychosis

Malar rash
Discoid rash

The presence of 4/11 criteria establishes the diagnosis of SLE.

4. Recommended Antibiotics for Pediatric Community-Acquired

Pneumonia (2012 Update)

1. For a patient who has been classified as pCAP A or B without previous

antibiotic,
1.1. Amoxicillin [40-50 mg/kg/day, maximum dose of 1500 mg/day in 3
divided dosesfor at most 7 days] is the drug of choice [Recommendation
Grade B].

1.1.1. Amoxicillin may be given for a minimum of 3 days

[Recommendation Grade A].

1.1.2. Amoxicillin may be given in 2 divided doses for a minimum of

5 days [Recommendation Grade B].

1.2. azithromycin [10 mg/kg/day OD for 3 days or 10mg/kg/day at day 1

then 5 mg/kg/day for days 2 to 5, maximum dose of 500mg/day], or
clarithromycin [15 mg/kg/day, maximum dose of 1000 mg/day in 2 divided
doses for 7 days] may be given to those patients with known
hypersensitivity to amoxicillin [Recommendation Grade D].

2. For a patient who has been classified as pCAP C, without previous

antibiotic,
2.1. requiring hospitalization, and

2.1.1. has completed the primary immunization against

Haemophilus influenza type b, penicillin G [100,000 units/kg/day in 4
divided doses] administered as monotherapy is the drug of choice
[Recommendation Grade B]

2.1.2. has not completed the primary immunization or immunization

status unknown against Haemophilus influenza type b, ampicillin [100
mg/kg/day in 4 divided doses] administered as monotherapy is the drug of
choice [Recommendation Grade B].


2.1.3. above 15 years of age [Recommendation Grade D], a
parenteral non- antipseudomonal -lactam (-lactam/-lactamase inhibitor
combination (BLIC), cephalosporin or carbapenem] + extended macrolide
[azithromycin or clarithromycin], or a parenteral non-antipseudomonal lactam [-lactam/ - lactamaseinhibitor
combination(BLIC],cephalosporinorcarbapenem]+ respiratory
fluoroquinolones [levofloxacin or moxifloxacin] administered as
combination therapy may be given [Recommendation Grade A].

2.2. who can tolerate oral feeding and does not require oxygen support,
amoxicillin [40-50 mg/kg/day, maximum dose of 1500 mg/day in 3 divided
doses for at most 7 days] may be given on an outpatient basis
[Recommendation Grade B].

5. Causes of Cellulitis

Most common organisms implicated are Staphylococcus aureus,

Streptococcus pyogenes, hemophilus influenza type b, Prevotella spp, B
fragilis group and Clostridium species.However usually infection is
polymicrobial that includes anaerobic bacteria and isolation of a single
organism is often not possible. Hib is most common cause of periorbital
and orbital cellulitis.