Neonates < 1 month

- If clinical suspician or LP evidence of meningitis, see Meningitis section.

- If blood or CSF cultures grow Gram negative bacilli within 24 hours, use meropenem empirically.

 
Usual Pathogens

Group B Streptococci
E. coli
S. aureus/MRSA
Coagulase negative Staph

 
Less common:

Listeria spp
H. influenzae
Enterococcus spp
Other Enterobacterales
Herpes simplex virus

 

Empiric Therapy Dose Duration
Ampicillin 200mg/kg/d IV div q6h Reassess at 48h with culture results.
+    
[Gentamicin 4-5mg/kg IV q24h  
or    
Cefotaxime] 200mg/kg/d IV div q6h  
+/-    
Acyclovir 60mg/kg/d IV div q8h  

If MRSA suspected, add:

Empiric Therapy Dose Duration
Vancomycin 45mg/kg/d IV div q8h Reassess at 48h with culture results.