Sandbox endocarditis2

Revision as of 17:26, 14 January 2014 by Ahmed Zaghw (talk | contribs)
Jump to navigation Jump to search

Medical Therapy

Pharmacotherapy

Empiric Treatment

  • Do not wait for the results of the CT scan and the lumbar puncture; empiric treatment should be started as soon as possible.
  • Blood cultures should be drawn before starting the antibiotic therapy, and then the antibiotic treatment should be changed once the blood culture results are out.
  • Empiric antibiotic treatment should be started within 30 minutes after the patient presentation.
  • In case of high suspicion of pneumococcal meningitis in adult patients, 0.15 mg/kg IV Q6H dexomethasone should be administered for 2 to 4 days.
    • The first dose of dexomethasone is given along with or 20 minutes prior to starting the antibiotics treatment.
Age <1 Week
Preferred Regimen
Ampicillin 50 mg/kg IV q8h
AND
Cefotaxime 100—150 mg/kg/day IV q8—12h
Alternative Regimen
Ampicillin 50 mg/kg IV q8h
AND
Gentamicin 2.5 mg/kg IV q12h


Age <1 Week
Preferred Regimen
Ampicillin 50 mg/kg IV q8h
AND
Cefotaxime 100—150 mg/kg/day IV q8—12h
Alternative Regimen
Ampicillin 50 mg/kg IV q8h
AND
Gentamicin 2.5 mg/kg IV q12h
Age 1—4 Weeks
Preferred Regimen
Ampicillin 200 mg/kg/day IV q6—8h
AND
Cefotaxime 150—200 mg/kg/day IV q6—8h
Alternative Regimen
Ampicillin 200 mg/kg/day IV q6—8h
AND
Gentamicin 2.5 mg/kg IV q8h
OR
Tobramycin 2.5 mg/kg IV q8h
OR
Amikacin 10 mg/kg IV q8h
Age 1—23 Months
Preferred Regimen
Ampicillin 200 mg/kg/day IV q6—8h
AND
Cefotaxime 150—200 mg/kg/day IV q6—8h
Alternative Regimen
Ampicillin 200 mg/kg/day IV q6—8h
AND
Gentamicin 2.5 mg/kg IV q8h
OR
Tobramycin 2.5 mg/kg IV q8h
OR
Amikacin 10 mg/kg IV q8h
Age 1—4 Weeks
Preferred Regimen
Ampicillin 200 mg/kg/day IV q6—8h
AND
Cefotaxime 150—200 mg/kg/day IV q6—8h
Alternative Regimen
Ampicillin 200 mg/kg/day IV q6—8h
AND
Gentamicin 2.5 mg/kg IV q8h
OR
Tobramycin 2.5 mg/kg IV q8h
OR
Amikacin 10 mg/kg IV q8h


References