GBS or Streptococcus agalactiae (Infants and Children)

Duration of Therapy

14-21 Days

Regimen of Choice

Penicillin-G 66,500 units/kg/dose IM/IV q4h

Dose limit: 24 million units/day (4 million units/dose)

OR

Ampicillin 50-100 mg/kg IV q6h

Dose limit: 12 g/day (3 g/dose)

Beta-lactam Allergy

Ceftriaxone

Greater than 1 month of age
100 mg/kg IV at 0, 12, and 24 h followed by 100 mg/kg IV q24h or 50 mg/kg IV q12h

Dose limit: 4 g/day (2 g/dose)

OR

Cefotaxime

50 mg/kg IV/IM q6h

Up to 75 mg/kg/dose may be used in selected cases in consultation with ID.

Dose limit: 12 g/day

Penicillin/Beta-lactam Allergy

If the patient has a true history of IgE mediated penicillin or beta-lactam allergy, the risks versus benefit of empiric treatment of suspected meningitis with appropriate antimicrobials should be discussed.