Page 221 - HPP ANTIMICROBIAL GUIDELINE 2018

Infection/Condition Suggested Treatment Comments
Preferred Alternative
Cryptococcal meningitis
Cryptococcus neoformans
Induction therapy: Amphotericin B 1.0mg/kg/24h IV

PLUS/ MINUS
Flucytosine 400-1200mg/m 2
(max 2gm) PO in q6h for 2-4 weeks.

Consolidation therapy: Fluconazole 10-12mg/kg/24h PO in
q12h for 8-10 weeks.

Herpes Simplex Encephalitis
< 12 weeks old: Acyclovir 20mg/kg IV q8h Duration: for 21 days

2
12 weeks-12 years old: Acyclovir 500mg/m IV q8h

> 12 years olds: Acyclovir 10mg/kg IV q8h

Brain abscess Cefotaxime 50mg/kg IV q4-6h If secondary to trauma: Surgical drainage may be indicated
if appropriate
OR ADD
Ceftriaxone 50-75mg/kg IV q12-24h Cloxacillin 25-50mg/kg IV q4-6h. Duration 6-8 weeks, depending on
response as seen from
PLUS neuroimaging
Metronidazole 15mg/kg IV stat then
7.5mg/kg IV q8h

References :
1. NICE Clinical Guideline (2010). Bacterial meningitis and meningococcal septicaemia
2. Royal Children Hospital Melbourne (2012). Meningitis/encephalitis guideline
3. The Sanford Guide to Antimicrobial therapy 2011-2012
4. Felsenstein S,Bhanu W, Shingadia D, et al. Clinical and Microbiologic Features Guiding Treatment Recommendations for Brain Abscesses in
Children.Pediatr Infect Dis J 2013;32:129-135.
5. Drug Doses Frank Shann

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