Page 241 - HPP ANTIMICROBIAL GUIDELINE 2018

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