Consult specialist/Infectious Diseases is recommended
At HGH, resistance to penicillin is 0%
AND
Ensure pharmacy consult for dosing
AND
For Listeria
+/-
Dexamethasone 0.15 mg/kg IV q6h x 2-4 days
Before or at start of antimicrobial therapy
If β-lactam allergy considered very severe contact TOH ID
AND
Ensure pharmacy consult for dosing
AND
For Listeria
+/-
Dexamethasone 0.15 mg/kg IV q6h x 2-4 days
Before or at start of antimicrobial therapy
May stepdown once patient improving clinically and supported by culture/sensitivities
On Day 3, or when culture and susceptibility results are available, tailor antimicrobial therapy to pathogen
S. pneumoniae: 10-14 days
N. meningitidis: 5-7 days
H. influenzae: 7 days
Listeria monocytogenes: >21 days
Enterobacteriaceae: 21 days