Page 65 - HPP ANTIMICROBIAL GUIDELINE 2018

Suggested Treatment
Infection/ Condition Comments
Preferred Alternative

Prophylaxis for household and Ciprofloxacin 500mg PO as single Ceftriaxone 250mg IM as single dose Close contacts are defined as those
close contacts of meningococcal dose (especially in pregnancy and individuals who have had contact for
meningitis cases lactating mothers) > 8 hours and within 1 meter of the
(age > 12 years) OR index case. Individuals who were in
Rifampicin 600mg PO q12h for OR contact with oropharyngeal
2 days (4 doses) [not recommended Azithromycin 500mg PO as single secretions of the index case in the
in pregnant women] dose. last 7 days before onset of
symptoms up to 24 hours after
appropriate antibiotics should also
Prophylaxis for children < 12 years Ciprofloxacin 250 mg as single dose receive chemoprophylaxis.
(age 5-12 years) or
125 mg (age < 5 years) For index case who received only
benzylpenicillin as therapy,
OR chemoprophylaxis should also be
Rifampicin 10 mg/kg q12H for 2 days given upon discharge to eliminate
nasopharyngeal carriage

Listeriosis Ampicillin 2gm IV q4h Trimethoprim(TMP)/ Duration of treatment is 3 weeks
OR Sulfamethoxazole (80/400mg) TMP depending on clinical response
Benzylpenicillin 4MU IV q4h 10 to 20 mg/kg/day IV in 4 divided
doses Gentamicin is given until symptoms
PLUS/MINUS improve (minimum of 1 week)

Gentamicin 4-7mg/kg/day IV in
3 divided doses

Brain abscess/subdural Ceftriaxone 2 gm IV q12h Cefotaxime 2 gm IV q4-6h Duration to be determined by clinical
empyema response, usually 2-6 weeks.
PLUS PLUS
Metronidazole 500mg IV q8h Metronidazole 500mg IV q8h

HPP AMG Central Nervous Infections 27