Group B streptococcal infection medical therapy: Difference between revisions
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===Empirical Antibiotic Therapy in Neonatal Meningitis=== | ===Empirical Antibiotic Therapy in Neonatal Meningitis=== | ||
GBS should be suspected as a causative agent for bacterial meningitis in infants less than two years of age for whom empirical antibiotic therapy should be initiated immediately. | GBS should be suspected as a causative agent for bacterial meningitis in infants less than two years of age for whom empirical antibiotic therapy should be initiated immediately. | ||
Shown below is a table depicting the choice of empirical medical therapy in neonatal meningitis.<ref name="pmid15494903">{{cite journal| author=Tunkel AR, Hartman BJ, Kaplan SL, Kaufman BA, Roos KL, Scheld WM et al.| title=Practice guidelines for the management of bacterial meningitis. | journal=Clin Infect Dis | year= 2004 | volume= 39 | issue= 9 | pages= 1267-84 | pmid=15494903 | doi=10.1086/425368 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=15494903 }} </ref> | |||
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===Targeted Antibiotic Therapy in Neonatal Meningitis=== | ===Targeted Antibiotic Therapy in Neonatal Meningitis=== | ||
Shown below is a table depicting the choice of targeted medical therapy in neonatal meningitis.<ref name="pmid15494903">{{cite journal| author=Tunkel AR, Hartman BJ, Kaplan SL, Kaufman BA, Roos KL, Scheld WM et al.| title=Practice guidelines for the management of bacterial meningitis. | journal=Clin Infect Dis | year= 2004 | volume= 39 | issue= 9 | pages= 1267-84 | pmid=15494903 | doi=10.1086/425368 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=15494903 }} </ref> | |||
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===Recommended Dosage of Antibiotics=== | ===Recommended Dosage of Antibiotics=== | ||
Shown below is a table summarizing the recommended dosage of antibiotics according to the IDSA guidelines.<ref name="pmid15494903">{{cite journal| author=Tunkel AR, Hartman BJ, Kaplan SL, Kaufman BA, Roos KL, Scheld WM et al.| title=Practice guidelines for the management of bacterial meningitis. | journal=Clin Infect Dis | year= 2004 | volume= 39 | issue= 9 | pages= 1267-84 | pmid=15494903 | doi=10.1086/425368 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=15494903 }} </ref> | |||
Shown below is a table summarizing the recommended dosage of antibiotics according to the IDSA guidelines. | |||
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Revision as of 22:13, 19 August 2014
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Rim Halaby, M.D. [2]
Overview
Medical Therapy in Neonatal Meningitis
Empirical Antibiotic Therapy in Neonatal Meningitis
GBS should be suspected as a causative agent for bacterial meningitis in infants less than two years of age for whom empirical antibiotic therapy should be initiated immediately.
Shown below is a table depicting the choice of empirical medical therapy in neonatal meningitis.[1]
| Age | Possible pathogens causing the bacterial meningitis | Empirical treatment |
| < 1 month | Streptococcus agalactiae Escherichia coli Listeria monocytogenes Klebsiella |
Ampicillin + cefotaxime OR Ampicillin + aminoglycoside |
| 1-23 months | Streptococcus pneumoniae Neisseria meningitidis Streptococcus agalactiae Haemophilus influenzae E. coli |
Vancomycin + third generation cephalosporin |
Targeted Antibiotic Therapy in Neonatal Meningitis
Shown below is a table depicting the choice of targeted medical therapy in neonatal meningitis.[1]
| Recommended therapy for GBS meningitis | Alternative therapy for GBS meningitis |
| Ampicillin OR Penicillin Consider adding an aminoglycoside |
Third generation cephalosporin (Ceftriaxone or cefotaxime) |
Recommended Dosage of Antibiotics
Shown below is a table summarizing the recommended dosage of antibiotics according to the IDSA guidelines.[1]
| Antibiotic agent | Dosage |
| Amikacin | 0-7 days: 15-20 mg/kg
8-28 days: 30 mg/kg Infants > 28 days: 20-30 mg/kg |
| Ampicillin | 0-7 days: 150 mg/kg
8-28 days: 200 mg/kg Infants > 28 days: 300 mg/kg |
| Cefotaxime | 0-7 days: 100-150 mg/kg
8-28 days: 150-200 mg/kg Infants > 28 days: 225-300 mg/kg |
| Ceftazidime | 0-7 days: 100-150 mg/kg
8-28 days: 150 mg/kg Infants > 28 days: 150 mg/kg |
| Ceftriaxone | Infants > 28 days: 80-100 mg/kg |
| Gentamicin | 0-7 days: 5 mg/kg
8-28 days: 7.5 mg/kg Infants > 28 days: 7.5 mg/kg |
| Penicillin G | 0-7 days: 0.15 mg/kg
8-28 days: 0.2 mg/kg Infants > 28 days: 0.3 mg/kg |
| Tobramycin | 0-7 days: 5 mg/kg
8-28 days: 7.5 mg/kg Infants > 28 days: 7.5 mg/kg |
| Vancomycin | 0-7 days: 20-30 mg/kg
8-28 days: 30-45 mg/kg Infants > 28 days: 60 mg/kg |
Consider lower dosages and longer intervals of antibiotics in case of very low-birth weight neonates.
References
- ↑ 1.0 1.1 1.2 Tunkel AR, Hartman BJ, Kaplan SL, Kaufman BA, Roos KL, Scheld WM; et al. (2004). "Practice guidelines for the management of bacterial meningitis". Clin Infect Dis. 39 (9): 1267–84. doi:10.1086/425368. PMID 15494903.