Page 209 - HPP ANTIMICROBIAL GUIDELINE 2018

Suggested Treatment
Infection/Condition Comments
Preferred Alternative

Rheumatic fever Benzathine penicillin G IM Penicillin V 250mg PO q12h Duration
(Secondary prevention) 1.2 MU (>25kg) ; With carditis: 10 yo or until 21 yo
0.6 MU (<25 kg) Penicillin Allergy :
every 3-4 weeks Erythromycin stearate 250mg With carditis and residual heart disease:
PO q12h 10 years or until 40 yo

Without carditis: 5 yo or until 21 yo

Neonatal Group B Strep Intrapartum maternal Ampicillin 2gm IV load then Treat during labour if previously delivered infant with
Infection prophylaxis till delivery 1gm q6h invasive GBS, GBS bacteriuria or antenatal screening
Penicillin G IV swabs positive
(5MU load then 2.5MU q6h Penicillin allergy
till delivery) Clindamycin 900mg IV q8h OR
(according to susceptibility) if GBS status not known AND any of the following:
• Preterm <37 weeks
OR • PROM >18 hours
Vancomycin (weight based • Intrapartum temp >38ºC
dosing 20mg/kg, max 2gm
q12h)

References:
1. Davies JM, Lewis MP, Wimperis J et al. Review of guidelines for the prevention and treatment of infection in patients with an absent or dysfunctional
spleen: prepared on behalf of the British Committee for Standards in Haematology by a working party of the Haemato-Oncology task force. Br J
Haematol. 2011;155:308-17
2. American Academy of Pediatrics. Haemophilus influenzae infections. In: Red Book: 2012 Report of the Committee on Infectious Diseases, 29th,
Pickering LK. (Ed), American Academy of Pediatrics, Elk Grove Village, IL 2012. p.345
3. American Academy of Pediatrics. Pertussis (whooping cough). In: Red Book: 2012 Report of the Committee on Infectious Diseases, 29th, Pickering
LK. (Ed), American Academy of Pediatrics, Elk Grove Village, IL 2012. p.553
4. Updated recommendations for use of VariZIG--United States, 2013. Centers for Disease Control and Prevention (CDC). MMWR Morb Mortal Wkly
Rep. 201

HPP AMG Chemoprophylaxis 99