Plus

Rifampin (Rimactane) 10-20 mg/kg/day PO (max 600 mg/day) [C] PLUS

Pyrazinamide (PZA) 15-30 mg/kg/day PO (max 2 g/day) [C] PLUS

Ethambutol (Myambutol) 15-25 mg/kg/day PO (max 2.5 g/day) [B] OR

Streptomycin 20-40 mg/kg/day (max 1 g/day) [D] B. ADULTS

Isoniazid (INH) 5 mg/kg/day PO (max 300 mg/day) [C] PLUS

Rifampin (Rimactane) 10 mg/kg/day PO (max 600 mg/day) [C] PLUS

Pyrazinamide (PZA) 15-30 mg/kg/day PO (max 2 g/day) [C] PLUS

Ethambutol (Myambutol) 15-25 mg/kg/day PO (max 2.5 g/day) [B] OR

Course: Treatment regimens vary. Initiate therapy with all drugs simultaneously, and arrange appropriate follow-up. SEPSIS

Note: If patient condition permits, cultures should be obtained prior to antibiotic administration.

A. NEONATAL (UP TO 8 WEEKS OF AGE, NORMAL HOST) (Note two drug therapy)

Note: Ceftriaxone is no longer recommended in neonates due to the potential for biliary sludge pseudolithiasis. Cefotaxime (Claforan) 50 mg/kg IV/IM q8h (q12h if < 1 week old) [B] PLUS (to cover group B Strep and Listeria) Ampicillin 25 mg/kg IV/IM q6h (q8h if < 1 week old) [B]

Organisms: group B Strep, E. coli, Listeria, Klebsiella, Enterobacter, S. aureus, H. influenzae

B. INFANT/CHILD (NORMAL HOST)

1. Cefotaxime (Claforan) 50 mg/kg IV/IM q8h [B] OR

2. Ceftriaxone (Rocephin) 100 mg/kg IV or IM q24h [B]

Organisms: H. influenzae, S. pneumoniae, N. meningitidis, S. aureus

C. PEDIATRIC (IMMUNOCOMPROMISED) Regimen A

(Note two or three drug therapy) Ceftazidime (Fortaz) 50 mg/kg IV q8h [B] Mezlocillin (Mezlin) 50-75 mg/kg IV q 4-6 h [B] Ticarcillin (Ticar) 50 mg/kg IV q 4-6 h [B] Piperacillin (Pipracil) 50 mg/kg IV q 4-6 h [B] Ticarcillin/clavulanic acid (Timentin) 50 mg/kg IV q6h [B] Piperacillin/tazobactam (Zosyn) 100 mg/kg iV q8h [B] PLUS

Gentamicin (Garamycin) 2 mg/kg IV loading dose, then 1.7 mg/kg IV q8h (monitor serum levels) [D] OR Tobramycin (Nebcin) 2 mg/kg IV loading dose, then 1.7 mg/kg IV q8h (monitor serum levels) [D] OR Amikacin (Amikin) 5 mg/kg IV q8h (monitor serum levels) [D] PLUS/MINUS (if indwelling intravascular device present)

Vancomycin (Vancocin) 10 mg/kg IV q6h (max 1 g/dose; monitor serum levels) [C] Regimen B

(Note one or two drug therapy)

Imipenem (Primaxin) 30 mg/kg IV q8h [C] OR

Meropenem 40 mg/kg IV q8h [B]

PLUS/MINUS (if indwelling intravascular device present)

Vancomycin (Vancocin) 10 mg/kg IV q6h (max 1 g/dose; monitor serum levels) [C]

Organisms: Enterobacteriaceae, Pseudomonas sp., S. aureus, S. epidermidis, S. viridans, Corynebacterium sp.

D. PEDIATRIC PATIENTS WITH A SEVERE PENICILLIN ALLERGY

(Note two drug therapy)

Vancomycin (Vancocin) 10 mg/kg IV q6h (max 1 g/dose; monitor serum levels) [C] PLUS

1. Gentamicin (Garamycin) 2 mg/kg IV loading dose, then 1.7 mg/kg IV q8h (monitor serum levels) [D] OR

E. ADULT (NORMAL HOST) Regimen A

Ticarcillin/clavulanic acid (Timentin) 3.1 g IV q6h [B] Piperacillin/tazobactam (Zosyn) 3.375 g IV q6h [B] Imipenem (Primaxin) 500-1000 mg IV q8h [C] Meropenem 1 g IV q8h [B]

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