Febrile Neonate
<1 month of age:
Streptococcus agalactiae, E. coli, Listeria monocytogenes
>1 month of age:
S. pneumoniae, Neisseria meningitidis, H. influenza, late onset S. agalactiae
PLEASE NOTE: all dosages provided below assume a weight >2kg. If <2kg please refer to neonatal dosing guidelines.
PMA </=44 weeks or 0-28 days of age:
Ampicillin:
PNA ≤7 days: 300 mg/kg/day IV div q8h
PNA >7 days: 300 mg/kg/day IV div q6h
AND
Gentamicin 4mg/kg/day IV div q24h
CONSIDER**
Addition of Acyclovir 60mg/kg/day IV div q8h
REPLACE ampicillin and gentamicin if PMA >44 weeks and >28 days of age WITH:
Ceftriaxone 50mg/kg/day IV div q24h
Empiric Therapy & Alternative Regimens
Duration of Therapy & Clinical Pearls
*Please note, the provided antimicrobial regimens are recommended in those patients that are felt to warrant treatment based on their clinical presentation and diagnostic study findings.
**Strongly consider acyclovir in infants <28 days old, ill/septic appearing, have a history of maternal infection, have skin/eye/mouth lesions, seizures, elevated transaminase, and/or CSF pleocytosis.
For those patients for which CSF is obtained and demonstrates a pleocytosis, or for those patients with clinical concern for meningitis, please refer to the Bacterial Meningitis section for the most appropriate antimicrobial regimen.