When prescribing treatment for bacterial infections in children, doctors are increasingly turning to alternatives to traditional antibiotics. One such option is the use of bacteriophages for children, which act selectively and do not harm beneficial microflora. However, many parents are concerned: what is the correct dosage of bacteriophages for a child, and how can they avoid mistakes and achieve the expected results?

It's important to understand that phage dosages are not the same as those of conventional medications. They don't act by accumulation or intoxication, so the dosage calculation approach is unique.

Bacteriophage dosage for children: what does it depend on?

When prescribing phage preparations to children, the doctor must take into account several key factors: age, weight, location of the infection, the form of the drug, and the method of administration.

Infants are typically prescribed smaller doses of bacteriophages, but this doesn't mean the effect will be less pronounced. Phages have the ability to replicate—meaning, after entering the site of infection, they multiply within the causative bacteria. Therefore, a high initial dose isn't always necessary.

For example, for newborns with intestinal infections, 5–10 ml of liquid bacteriophage once or twice a day may be sufficient. For children aged 1 to 3 years, 10–15 ml is sufficient, and for preschoolers, up to 20 ml. However, these are only general guidelines. The final decision rests with the doctor.

It's equally important to consider the route of administration of bacteriophages to children. Oral administration is the most convenient and safest. If rectal microenemas are used, the volume of solution may be smaller. And with inhalation, phages are administered as an aerosol, where the volume is not always equal to the therapeutic dose in milliliters.

How to properly administer bacteriophages to a child: regimen and duration

Besides the dosage, the most important factor for children is the dosage regimen. It is recommended to take the bacteriophages one hour before meals.

The duration of treatment depends on the nature of the infection. For acute infections, 5–7 days is sufficient, while for chronic or protracted infections, the course may last 10–14 days, sometimes with a repeat treatment after a few weeks.

There is also prophylactic use—for example, after surgery or during epidemics. In such cases, the phage dosage for children is usually lower, and the course is shorter—3–5 days.

It's important to ensure that the child takes the phage unaltered: do not heat the solution or mix it with acidic drinks or hot foods. Also, do not open the vial long before use—viruses are sensitive to storage conditions, which can reduce their effectiveness.

When and how does a doctor adjust the dose of bacteriophages in children?

In some situations, individual adjustments to the bacteriophage dose for children are necessary. This may occur in the following cases:

• changes in the patient's condition (eg, exacerbation of symptoms);

• ineffectiveness of the initial treatment regimen;
  combinations with antibiotics;

• infections that do not respond to monotherapy.

The dosage may also be adjusted if the child has gastrointestinal dysfunction, and some phages are lost before reaching the site of action. In this case, the doctor may additionally prescribe rectal or inhalation forms of bacteriophages.

Some countries also use fractional administration schemes: for example, dividing the daily dose into 3–4 doses to maintain a constant concentration of active phages in the blood or affected organ.

It should be emphasized that self-adjusting phage dosages in children is strictly not recommended. Although bacteriophages are considered safe, overdosing or underdosing may either reduce their effectiveness or affect the child's microbiome.

Therefore, the correct dosage for children depends on a number of factors and should only be prescribed by a specialist. Phage therapy is a delicate and individualized treatment, where precision and adherence to the regimen are crucial.