Children > 3 months
- toxic
- shock
Recommend:
blood culture
consider lumbar puncture unless contraindicated
urine culture
S. pneumoniae
N. meningitidis
S. aureus/MRSA
Group A Streptococci
Occasionally:
H. influenzae
| Empiric Therapy | Dose | Duration |
|---|---|---|
| Ceftriaxone | 100mg/kg/d IV div q12h | See Duration |
Severe/shock/bacterial meningitis suspected
| Empiric Therapy | Duration | |
|---|---|---|
| Vancomycin | 60mg/kg/d IV div q6h | |
| + | ||
| Ceftriaxone | 100mg/kg/d IV div q12h | |
| If toxic shock suspected, add: | ||
| Clindamycin | 40mg/kg/d IV div q8h |
Alternative if ceftriaxone allergy
| Empiric Therapy | Duration | |
|---|---|---|
| TMP/SMX | 15-20mg TMP/kg/d IV div q6-8h | |
| + | ||
| Vancomycin | 60mg/kg/d IV div q6h | |
| If toxic shock suspected, add: | ||
| Clindamycin | 40mg/kg/d IV div q8h |