Page 240 - HPP ANTIMICROBIAL GUIDELINE 2018
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Infection/Condition                               Suggested Treatment                                         Comments
                                                                  Preferred                           Alternative

                 GBS Infection                 Penicillin G IV                                                          Duration:
                 Streptococcus agalactiae                                                                               Sepsis: 10 days
                                               OR                                                                       Meningitis: 14 days
                                               Ampicillin IV  (300mg/kg/day)                                            Osteomyelitis: 4 weeks

                                               PLUS
                                               Gentamycin IV


                 Postnatal Infections

                 Community Acquired            Inadequate evidence from randomised trials in favour of any particular antibiotic regimen for the treatment of suspected
                 Infections                    late onset neonatal sepsis
                 (Late onset sepsis >48 hrs)
                 Pneumonia, Sepsis             Discuss with ID/neonatologist / microbiologist for the prevalence pathogens
                 Group B Strep, E. coli,       Discontinue antibiotics after 72 hours if culture negative or course does not support diagnosis
                 Klebsiella, Enterobacter,
                 Staphylococcus aureus         Drug Dosages – Refer Frank Shann or Neofax
                 Possible Listeria
                                               Cloxacillin IV

                                               PLUS
                                               Gentamicin IV

                 Hospital Acquired Infection
                 (Pneumonia, sepsis,           CloxacillinIV                                     Cefepime               Possibility of GNB with inducible
                 meningitis)                                                                     (Discuss with          -lactamases and ESBL producing
                 Based on predominant flora    PLUS                                              ID/neonatologist /     Klebsiella and E. coli where -lactams
                 and susceptibility            Amikacin IV                                       microbiologist for the   are avoided and may require
                 Coagulase-negative                                                              prevalence pathogens)  carbepenems
                 staphylococci, Staphylococcus   (Use cloxacillin if Staph aureus is a problem in the
                 aureus, E. coli, Klebsiella,   respective nursery.
                 Pseudomonas, Enterobacter,    Otherwise replace Cloxacillin with any other antibiotic                  (Drug Dosages – Refer Frank Shann
                 Candida, GBS, Serratia,       appropriate for the predominant flora)                                   or Neofax)
                 Acinetobacter



               HPP AMG                                                       Neonatal Infections                                                        115
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