Guidelines
Neonates (< 1 mo)

Neonates (< 1 mo)

Empiric Therapy

  • PNA < 7 days
    • 200 to 300 mg/kg/day IV divided every 8 hours
  • PNA > 7 days
    • 300 mg/kg/day IV divided every 6 hours

PLUS EITHER

Cefotaxime

  • PNA < 7 days and > 2 kg
    • 100 to 150 mg/kg/day IV divided Q8-12H
  • PNA > 7 days and > 2 kg
    • 150 to 200 mg/kg/day IV divided Q6-8H

OR

No ceftriaxone due to increased risk of biliary sludging in neonates

Treatment Duration

Pathogen Dependent:

  • Neisseria meningitidis: 7 days
  • Haemophilus influenzae: 7 days
  • Streptococcus agalactiae: 14 - 21 days
  • Streptococcus pneumoniae: 10-14 days
  • Aerobic gram-negative bacilli: 2 weeks beyond the first sterile CSF culture or > 3 weeks, whichever is longer
  • Listeria monocytogenes: 21 days