Page 237 - HPP ANTIMICROBIAL GUIDELINE 2018
P. 237

Infection/Condition    Suggested Treatment     Comments
 Preferred        Alternative
                                  •
 Gonococcal                       •  Evaluate for signs of disseminated
                                   infection (e.g., sepsis, arthritis, and
 Ophthalmitis   Immediate and frequent saline eye irrigation      meningitis)
                                  •
                                  •  Screen mother and baby for
 Non-disseminated disease   Ceftriaxone 50mg/kg IV once (max 125mg)    chlamydial infection
                                  •
                                  •  Screen for other STDs
 st
 Disseminated disease   Ceftriaxone IV (50mg/kg daily 1  week of life, 12H   •  Investigate and treat parents
    >1week of life) for 7 days
    Duration 10-14 days if meningitis documented


 Neonates with   Cefotaxime 25 mg/kg IV/IM q12h for 7 days,
 hyperbilirubinemia   with a duration of 10–14 days, if meningitis is
 documented


 Chlamydia trachomatis   Initial treatment for chlamydial conjunctivitis should be based upon a positive diagnostic test
 conjunctivitis   Diagnosis by tissue culture, antigen detection (IFA, EIA) or NAAT
 Eye swab from conjunctiva of everted eyelid with Dacron tipped swab or swab from test kit
 Test also for gonococcus.
 Treat mother & sexual partner

 •  Efficacy of treatment 80%, follow-up necessary. Second course of treatment may be required.
 •

 Erythromycin base or ethylsuccinate 50mg/kg/day PO   Azithromycin 20
 q6h for 14 days   mg/kg/day PO, 1 dose
             daily for 3 days
 (Topical therapy not necessary if systemic treatment
 given)






 HPP AMG   Neonatal Infections                                     113
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