Neonates < 1 month
- Tailor antibiotics to C&S results.
- Repeat LP recommended at 48-72 hours for Listeria and Gram negative organisms. Some experts recommend repeat LP at 24-48 hours for Group B Streptococci.
- Consider need for acyclovir if HSV encephalitis possible.
- Corticosteroids are not currently recommended in neonatal meningitis due to different pathogens and lack of randomized controlled trial data.
Usual Pathogens
Group B Streptococci
E. coli
Listeria monocytogenes
| Empiric Therapy | Dose | Duration |
|---|---|---|
| Ampicillin | 300mg/kg/d IV div q6h | Group B Strep, Listeria spp - 2-3 weeks E. coli - ≥ 3 weeks |
| + | ||
| [Gentamicin | 4-5mg/kg IV q24h | |
| or | ||
| Cefotaxime] | 200mg/kg/d IV div q6h |