Spectrum: Local Antimicrobial Stewardship, for Prisma Health Children’s Hospital-Midlands

EOS ≥ 35 Weeks - Therapy

Empiric Treatment

Ampicillin

PLUS EITHER

Gentamicin

OR

Cefepime

If patient is hemodynamically unstable

Follow Up

When to Discontinue Antibiotics

Discontinue antibiotics if blood cx negative at 36hr unless:

  • Evidence of site-specific infection or unexplained critical cardiorespiratory illness

  • May obtain 36hr CBC with diff to help determine need to continue

When to Continue Antibiotics

Continue antibiotics if blood cx positive
* De-escalate to narrowest spectrum IV antibiotic based on susceptibility results
* Perform lumbar puncture and obtain meningoencephalitis PCR panel for CSF analysis
* Treatment duration to be determined based on organism isolated and site of infection

Continue antibiotics if blood cx negative if:

  • Evidence of site-specific infection or unexplained critical cardiorespiratory illness

  • May obtain 36hr CBC with diff to help determine need to continue

  • Treatment duration = 5 days

Continuing empirical antibiotic therapy in response to lab test abnormalities alone is rarely justified