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| == Bugs & Drugs<br> ==
| | #REDIRECT[[Pediatric antibiotics]] |
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| == Neonatal Infections<br> ==
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| NOTE: All doses listed below are for patients >2 kg and at least 7 days of age<br>
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| Any infant who has '''tachycardia out of proportion''' to fever or HR >180 in any age group has a serious bacterial infection (SBI) until proven otherwise. Other serious risk factors include lethargy, hyperventiliation, cyanosis, poor perfusion and hypotonia. Have a high suspicion and treat accordingly. Always treat for meningitis until you are sure it is not. Note that bacterial etiology and antimicrobial therapies are similar for all neonatal illnesses.<br>
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| {| cellspacing="0" cellpadding="2" border="1" align="left"
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| | rowspan="2" | Fever of Uncertain Source (FUS)
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| Neonatal (0-30 days): ''GBS, E. coli, Klebsiella, Enterobacter, Listeria or S. aureus'' (rare)<br>
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| Send blood, urine and CSF cultures. ''Listeria'', while infrequent at CCHMC, may sporadically occur in clustered cases.
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| #Ampicillin 200 mg/kg/day (if >2 kg) IV div Q6 AND Cefotaxime 200 mg/kg/day IV div Q6. | |
| #Ampicillin 200 mg/kg/day (if >2 kg) IV div Q6 AND Gentamicin 3.5 mg/kg/day IV Q24.
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| #Consider risk factors for neonatal HSV disease. Test and treat accordingly.
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| | Neonatal (30-60 days): See above.<br>
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| Workup: Blood and urine specimen. If low-risk (non-ill appearing), normal blood and urine analyses, parents and PMD okay, consider no LP, no antibiotics, and discharge home with f/u in 12-24 hours. Otherwise, LP + Abx.
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| #Cefotaxime 200 mg/kg/day IV div Q6 or Ceftriaxone1 100 mg/kg/day IV div Q12. If evidence of UTI or severly ill infant, add Ampicillin.<br>
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| | Meningitis<br>
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| | Preterm to 60 days: ''GBS'' (49%), ''E. coli ''(18%), ''Listeria ''(7%), ''misc GN's'', ''GP's''<br>
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| #Ampicillin 400 mg/kg/day (if >2 kg) IV div Q6 (if >7 days) AND Cefotaxime 200 mg/kg/day IV div Q6 (if >7 days)<br>
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| #Ampicillin 400 mg/kg/day (if >2 kg) IV div Q6 (if >7 days) AND Gentamicin 4 mg/kg/day IV Q24.<br>
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| If ''GBS'' meningitis, treat 21 days. If ''GN'' meningitis, treat 21 days (and >14 days after CSF sterilizes). Tailor therapy when specific etiology known
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| [[Image:Bugs and Drugs Page 01.png|962x646px|Bugs and Drugs Page 01.png]]<br> | |
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| [[Image:Bugs and Drugs Page 02.png|962x669px|Bugs and Drugs Page 02.png]]
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| [[Image:Bugs and Drugs Page 03.png|963x602px|Bugs and Drugs Page 03.png]]
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| [[Image:Bugs and Drugs Page 04.png|962x682px|Bugs and Drugs Page 04.png]]
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| [[Image:Bugs and Drugs Page 05.png|962x619px|Bugs and Drugs Page 05.png]]
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| <br>
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| [[Image:Bugs and Drugs Page 07.png|961x677px|Bugs and Drugs Page 07.png]]
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| [[Image:Bugs and Drugs Page 08.png|961x640px|Bugs and Drugs Page 08.png]]
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| [[Image:Bugs and Drugs Page 09.png|960x614px|Bugs and Drugs Page 09.png]]
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| [[Image:Bugs and Drugs Page 10 real.png|961x666px|Bugs and Drugs Page 10 real.png]]
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| [[Image:Bugs and Drugs Page 10.png|963x594px|Bugs and Drugs Page 10.png]]
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| == Source<br> ==
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| Cincinnati Children's Hospital "The Pocket" 2010-2011<br>
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| [[Category:Peds]] [[Category:ID]]
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| <br>
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