Sepsis or febrile illness (source unknown) - community acquired

Antimicrobial prescribing: NHS Forth Valley
NHS Forth Valley

Micro Organisms

Neonates - Group B strep, Gram -ve bacilli

1-3 months - Strep pneumoniae, N.meningitides, Listeria, H.influenza

> 3 months  - various pathogens

First Line

Therapy

Neonates - Benzylpenicillin + gentamicin IV for 5-7 days

1-3 months - Cefotaxime + amoxicillin +/- metronidazole IV for 7-10 days

> 3 months - Ceftriaxone for 7 to 10 days

Notes:

If Gentamicin not suitable - use cefotaxime +/- Benzylpenicillin

Anaphylaxis (or severe skin reaction) to penicillin - (Penicillin allergy)

Therapy

> 3 months - Vancomycin IV + Gentamicin IV + Metronidazole IV for 7-10 days

Notes:

If Gentamicin not suitable - use Cefotaxime + Metronidazole +/- Vancomycin (if MRSA suspected/confirmed)

 

 

Notes

If patient has central line or history of MRSA, consider addition of vancomycin

Add IV aciclovir if herpes simplex suspected (see BNFc for dosing and body weight considerations)

Add clindamycin IV if staphylococcal/streptococcal toxic shock until stable - usually 48 hours (Discuss IVIG with paeds ID/micro if unresponsive to antibiotics or life threatening)

Discuss with microbiology if no improvement