Page 276 - HPP ANTIMICROBIAL GUIDELINE 2018

VASCULAR INFECTIONS

Infection/Condition Suggested Treatment Comments
Preferred Alternative

Catheter Related Blood Indication of catheter removal are similar to
Stream Infection adult but benefit of catheter removal must be
S. epidermidis(CoNS) For infant and children: weight against the difficulties of obtaining
S. aureus Vancomycin 10-15 mg/kg/day IV q6h alternate venous access.

Treatment without catheter removal should
MSSA Cloxacillin IV 200 mg/kg/day q6h be closely monitored clinically with additional
blood culture; removed catheter if there is
persistent or recurrent infection
Candida albicans or Fluconazole 6-12 mg/kg IV q24h For children 3 months-17 years:
Other Candida species Caspofungin loading dose 70 Antibiotic lock therapy should be used for
mg/m³/day IV on day 1 followed by catheter salvage in combination with
50 mg/ m³/day thereafter (max conventional antibiotic therapy for 10-14
70mg) days. S.aureus may require longer course
up to 4-6 weeks
Gram –ve bacilli
(E.coli, Enterobacter, Exact optimal duration of therapy has not
Klebsiella, Pseudomonas, established in children with or without
Acinetobacter) catheter removal. 10-14 days after first
negative blood culture is usually
ESBL –ve Ceftriaxone/cefotaxime/ceftazidime recommended.

PLUS/MINUS Fungaemia: treatment without catheter
Aminoglycoside removal associated with low success rate
and higher mortality

ESBL +ve Imipenem/cilastatin 25mg/kg IV q6-8h

OR
Meropenem 20-40mg/kg IV q8h

HPP AMG Vascular Infections 133