Table 201-2
Indication | Antibiotic |
Preterm infants to infants < 1 month | Ampicillin + cefotaxime |
Infants 1–3 mos | Ampicillin + cefotaxime or ceftriaxone |
Immunocompetent children >3 mos and adults < 55 | Cefotaxime or ceftriaxone + vancomycin |
Adults >55 and adults of any age with alcoholism or other debilitating illnesses | Ampicillin + cefotaxime or ceftriaxone + vancomycin |
Hospital-acquired meningitis, posttraumatic or postneurosurgery meningitis, neutropenic patients, or patients with impaired cell-mediated immunity | Ampicillin + ceftazidime + vancomycin |
Antimicrobial Agent | Total Daily Dose and Dosing Interval |
Child (>1 month) | Adult |
Ampicillin | 200 (mg/kg)/d, q4h | 12 g/d, q4h |
Cefepime | 150 (mg/kg)/d, q8h | 6 g/d, q8h |
Cefotaxime | 200 (mg/kg)/d, q6h | 12 g/d, q4h |
Ceftriaxone | 100 (mg/kg)/d, q12h | 4 g/d, q12h |
Ceftazidime | 150 (mg/kg)/d, q8h | 6 g/d, q8h |
Gentamicin | 7.5 (mg/kg)/d, q8ha | 7.5 (mg/kg)/d, q8h |
Meropenem | 120 (mg/kg)/d, q8h | 3 g/d, q8h |
Metronidazole | 30 (mg/kg)/d, q6h | 1500–2000 mg/d, q6h |
Nafcillin | 100–200 (mg/kg)/d, q6h | 9–12 g/d, q4h |
Penicillin G | 400,000 (U/kg)/d, q4h | 20–24 million U/d, q4h |
Vancomycin | 60 (mg/kg)/d, q6h | 2 g/d, q12ha |
*All antibiotics are administered intravenously; doses indicated assume normal renal and hepatic function.
aDoses should be adjusted based on serum peak and trough levels: gentamicin therapeutic level: peak: 5–8 μg/mL; trough: < 2 μg/mL; vancomycin therapeutic level: peak: 25–40 μg/mL; trough: 5–15 μg/mL.
Table 201-2: Antibiotics Used in Empirical Therapy of Bacterial Meningitis and Focal CNS Infections* has been found in Harrison's Manual of Medicine 17/e
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