Sepsis, greater than or equal to 4 weeks of age

Most likely pathogens

Duration of therapy

Reassess at 36 to 48 hours
10-14 days (without an additional focus)

Meningococcus: 7 days (without additional focus)

Pneumococcus: 10 days (without additional focus)

Ceftriaxone 100 mg/kg/dose IV q24h
Maximum: 2000 mg/dose

If meningitis suspected:

Ceftriaxone 100 mg/kg/dose IV x 1 dose, then 12 hours later:
Ceftriaxone 50 mg/kg/dose IV q12h
Maximum: 2000 mg/dose

AND

Vancomycin 15 mg/kg/dose IV q6h
Maximum: 1000 mg/dose prior to levels

Ceftriaxone 100 mg/kg/dose IV q24h
Maximum: 2000 mg/dose

If meningitis suspected:

Ceftriaxone 100 mg/kg/dose IV x 1 dose, then 12 hours later:
Ceftriaxone 50 mg/kg/dose IV q12h
Maximum: 2000 mg/dose

AND

Vancomycin 15 mg/kg/dose IV q6h
Maximum: 1000 mg/dose prior to levels