Paediatric
Meningitis (under 1 month)
This antibiotic choice is for babies admitted through the Emergency Department or on the paediatric wards. For babies on the neonatal unit / postnatal wards, refer to the neonatal guidelines
Preferred
amoxicillin iv (see dosing table below)
AND
cefotaxime 50mg/kg bolus (Max 4g) iv initially in ED then EITHER:
- continue cefotaxime (see dosing table below) OR
- change to ceftriaxone (see dosing table below) once stable on the ward AND if 41 weeks or over corrected gestational age AND NOT receiving iv calcium.
Consider need for aciclovir
cefotaxime iv dosing
| Age | cefotaxime iv dose |
| Up to 7 days old | 50mg/kg every 12 hours |
| 7 to 20 days old | 50mg/kg every 8 hours |
| 21 to 28 days old | 50mg/kg every 6 hours |
amoxicillin iv dosing
| Age | amoxicillin iv dose |
| Up to 7 days old | 50mg/kg every 12 hours |
| 7 to 28 days old | 50mg/kg every 8 hours |
ceftriaxone iv dosing
| Age | ceftriaxone iv dose |
| Up to 15 days old | 50mg/kg iv OD |
| 15 days to 28 days old | 80mg/kg iv OD |
For MRSA positive patients: ADD vancomycin iv
For penicillin allergy (non-severe)
cefotaxime 50mg/kg bolus (Max 4g) iv initially in ED then EITHER:
- continue cefotaxime (see dosing table below) OR
- change to ceftriaxone (see dosing table below) once stable on the ward AND if 41 weeks or over corrected gestational age AND NOT receiving iv calcium
and consult Paediatric ID
Consider need for aciclovir
cefotaxime iv dosing
| Age | cefotaxime iv dose |
| Up to 7 days old | 50mg/kg every 12 hours |
| 7 to 20 days old | 50mg/kg every 8 hours |
| 21 to 28 days old | 50mg/kg every 6 hours |
OR
ceftriaxone iv dosing
| Age | ceftriaxone iv dose |
| Up to 15 days old | 50mg/kg iv OD |
| 15 days to 28 days old | 80mg/kg iv OD |
For MRSA positive patients: ADD vancomycin iv
For penicillin allergy (severe)
Consult Paediatric ID