According to the Infectious Diseases Society of America , which children with upper respiratory traction infection (URI) symptoms (nasal congestion, rhinorrhea, or cough) should receive antibiotics? Which antibiotic?

• persistent symptoms greater than or equal to 10 days 
• severe symptoms (temperature greater than 38.5 C or 101.4 F for 3-4 days or purulent rhinorrhea for 3-4 days)
• return of symptoms after initial resolution 

While viral URIs are common in children, the above symptoms are suggestive of a bacterial infection (sinusitis) and warrant treatment with antibiotics.   The antibiotic of choice is amoxicillin-clavulanate.  Alternatives include cephalosporins (cefuroxime, cefpodoxime, cefdinir) and levaquin. Macrolides and trimethoprim-sulfamethoxazole are no longer recommended given changing susceptibility patterns.

PS.  levaquin is safe in children despite what many of us were taught


Source

DeMuri, G. and Wald, E.  "Acute Bacterial Sinusitis in Children"  NEJM.  20 Sept 2012.

Playe, S.  "Quinolones for Kids?  The Good News is the Bad News"  Emergency Medicine News. March 2007.