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Guidelines
Pathogens
Antimicrobials
10 days
Transition from empiric to definitive therapy should occur once GBS is identified by culture; clinical improvement is evident and and for meningitis, only when CSF is sterile at 24 to 48 hours of therapy.
Vancomycin (See Dosing Below)
PMA Less Than 27 Weeks
24 mg/kg IV q24h
PMA 27 - 36 Weeks
18 mg/kg IV q12h
PMA 37 Weeks or More
22.5 mg/kg IV q12h
PLUS EITHER
Gentamicin (See Dosing Below)
7 Days of Age
PMA Less Than 34 Weeks 3 mg/kg IV q24h
PMA 34 Weeks or More 3 mg/kg IV q18h
More Than 7 Days of Age
1 kg or Less 3.5 mg/kg IV q24h
More Than 1 kg PMA Less Than 37 Weeks 2.5 mg/kg IV q12h
PMA 37 Weeks or More 2.5 mg/kg IV q8h
OR
Cefotaxime (See Dosing Below)
2 kg or Less 50 mg/kg IV/IM q12h
Over 2 kg 50 mg/kg IV/IM q8h-q12h
**Less Than
1.2 kg** 50 mg/kg IV/IM q12h
1.2 - 2 kg 50 mg/kg IV/IM q8h
Over 2 kg 50 mg/kg IV/IM q6h-q8h
Penicillin G (See Dosing Below)
Less than 2 kg 25,000 units/kg IV/IM q12h
2 kg or more 25,000 units/kg IV/IM q8h
Less than 1.2 kg 25,000 units/kg IV/IM q12h
1.2 - 2 kg 25,000 units/kg IV/IM q8h
2 kg or More 25,000 units/kg IV/IM q6h
