Sepsis 1 month and over
Preferred including penicillin allergy (non-severe)
cefotaxime 50mg/kg (Max 4g) iv bolus initially in ED
then either:
- Continue cefotaxime 50mg/kg (Max 4g) iv QDS (maximum per day: 12g), OR
- If stable on the ward AND 41 weeks or over corrected gestational age AND NOT receiving iv calcium change to ceftriaxone 80mg/kg (Max 4g) iv OD
For MRSA positive patients: ADD vancomycin iv
If meningitis suspected then see Meningitis (1 month and over)
Review once microbiology results available.
Alternative
For penicillin allergy (severe)
ciprofloxacin* 10mg/kg (Max 400mg) iv TDS AND vancomycin iv
OR
chloramphenicol 25mg/kg (Max 1g) iv single dose THEN consult Paediatric ID/Micro
For MRSA positive patients
ciprofloxacin* 10mg/kg (Max 400mg) iv TDS AND vancomycin iv
If meningitis suspected then see Meningitis (1 month and over)
Review once microbiology results available.
* Note: Ciprofloxacin may induce convulsions in patients with or without a history of convulsions – use with caution
Also Note: If patient is prescribed ciprofloxacin ensure that the patient is given the Fluoroquinolone MHRA patient information leaflet.
For more information about MHRA safety alerts and patient or carer counselling See Fluoroquinolone antibiotics - paediatric position statement