Page 243 - HPP ANTIMICROBIAL GUIDELINE 2018

Infection/Condition Suggested Treatment Comments
Preferred Alternative

Necrotising Enterocolitis There is insufficient evidence regarding choice of antibiotic regimens or duration of antibiotic treatment of NEC.
(NEC) Decisions regarding antibiotic choice and duration might best be guided by culture results as well as flora & antibiotic
Klebsiella, E. coli, Clostridia, resistance patterns present within nurseries
coagulase negative Empiric regimens can be modified based upon the results of cultures of blood, peritoneal fluid, or surgical specimens
Staphylococcus, Enterococci,
Bacteroides
(typically NEC occurs at Ampicillin IV Amoxicillin/clavulanate Duration
second or third week of life) PLUS 10-14 days
PLUS Gentamicin
Gentamycin IV (Vancomycin if CoNS MRSA or VRE
OR suspected)
PLUS Amikacin
Metronidazole IV

References
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1. American Academy of Pediatrics. 2012 Red Book: Report of the Committee on Infectious Diseases. 29 ed. Elk Grove Village, IL: American Academy of
Pediatrics.
2. Workowski KA, Berman S Sexually transmitted diseases treatment guidelines, 2010. , Centers for Disease Control and Prevention (CDC) MMWR Recomm
Rep. 2010;59(RR-12):1.
3. Kimberlin, D.W., Neonatal Herpes simplex infectio . Clinical Microbiology reviews. 2004;17:1-13
4. American Academy of Pediatrics. 2003 Red Book: Report of the Committee on Infectious Diseases. 26 ed. Elk Grove Village, IL: American Academy of
th
Pediatrics, 2003:611-616
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5. American Academy of Pediatrics. 2003 Red Book: Report of the Committee on Infectious Diseases. 26 ed. Elk Grove Village, IL: American Academy of
Pediatrics, 2003:285-291
6. Mtitimila EI, Cooke RWI. Antibiotic Regimens for suspected early-onset sepsis. Cochrane Database of Systematic Reviews. 2006. Issue 4.
7. Antibiotics for early-onset neonatal infection. NICE clinical guideline 149. Aug 2012
8. Gordon A, Jeffrey HE. Antibiotic Regimens for suspected late-onset sepsis in newborn. Cochrane Database of Systematic Reviews. 2006. Issue 4
9. Shah D, Sinn JK. Antibiotic regimens for the empirical treatment of newborn infants with necrotising enterocolitis Cochrane Database Syst Rev.
2012;8:CD007448.
10. Centers for Disease Control and Prevention. STD Surveillance case definitions. http://www.cdc.gov/std/stats/CaseDefinitions-2014.pdf

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