Spectrum: Local Antimicrobial Stewardship, for UCLA Health

Severely Ill

Criteria

  • Concern for respiratory failure

  • Sepsis

  • Altered mental status

Admit Patient

PICU

Recommended Antibiotic Regimen

Vancomycin 45mg/kg/day IV divided TID
Max dose: 2g per day
Target vancomycin levels 15-20

AND

Ceftriaxone 50mg/kg/day IV in once daily dosing.
Consider 100mg/kg/day IV divided daily or BID for severe infection
Max dose: 2g per day

CONSIDER ADDING

Azithromycin 10mg/kg/day PO/IV in a once daily dose on day 1,
Max dose: 500mg
followed by 5mg/kg/day in once daily dosing on days 2-5
Max dose: 250mg

Additional Recommendations

Respiratory support as necessary

Obtain blood gas

IVF resuscitation and support

Recommendations for Influenza

Concern for parapneumonic effusion on CXR?

Chest US (CT is second line): ID consult recommended