Usual Pathogens

Group B Streptococci
Enterobacterales
Listeria monocytogenes

 

If VLBW in NICU (particularly with CVL):

Coagulase negative Staph (CoNS)
Candida spp

 

Empiric Therapy

Dose

Duration
Ampicillin

300mg/kg/d IV div q6h

Gram positive: ≥ 14 days
Gram negative: ≥ 21 days
+    
[Gentamicin 4-5mg/kg IV q24h  
or    
Cefotaxime] 200mg/kg/d IV div q6h  

If failure of above regimen or colonized with cefotaxime-resistant Gram negative or Gram negative grows in blood or CSF cultures

Empiric Therapy

Dose

Duration
Meropenem 90mg/kg/d IV div q8h Gram positive: ≥ 14 days
Gram negative: ≥ 21 days
If failure of meropenem or Gram positive cocci grows in blood or CSF cultures, add:    

Vancomycin

45mg/kg/d IV div q8h  

Candida spp

Empiric Therapy Dose Duration
Amphotericin B 0.7-1mg/kg IV daily Min. 2 weeks after resolution of all signs & symptoms
+/-    
Flucytosine 25mg/kg IV/PO qid  
Alternative    
Fluconazole 12mg/kg IV/PO daily Min. 2 weeks after resolution of all signs & symptoms