Page 234 - HPP ANTIMICROBIAL GUIDELINE 2018
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Infection/Condition                               Suggested Treatment                                         Comments
                                                                  Preferred                           Alternative

                 Tetanus neonatorum          •  Debridement
                                             •  Human tetanus IG IM
                                               Optimum dose for IM human TIG yet to be established.
                                               Traditional recommendations: single dose of 3000-6000U.
                                               Limited data suggests doses as low as 500U as effective.

                                               Penicillin - GABA antagonist and associated with seizures. Metronidazole recommended as choice.

                                               Check maternal immunization


                                               Metronidazole IV/PO for 10 days                   Penicillin G IV
                                                                                                 (100 000U/kg q12h for
                                               Neonates (Neofax dosing):                         1st week of life and
                                                                                                          st
                                               •  Loading dose: 15mg/ kg/dose IV/PO x 1          q6h after 1  week) for
                                               •  Maintenance dose: 7.5mg/ kg/dose IV/PO         10 days

                                                Metronidazole Dosing Interval Chart
                                                Post-menstrual     Post-natal    Dosing
                                                age (weeks)        age (days)    interval
                                                                                 (hours)
                                                ≤ 29 weeks         0-28 days     q48h
                                                                   >28 days      q24h
                                                30 to 36 weeks     0-14 days     q24h
                                                                   >14 days      q12h
                                                37 to 44 weeks     0-7 days      q24h
                                                                   >7 days       q12h
                                                ≥ 45 weeks         AL            q8h










               HPP AMG                                                       Neonatal Infections                                                        112
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