Common meds

acyclovir

60 mg/kg/day IV divided q 8 h x 14-21 days - infuse over 1 h
20 mg/kg/dose q 24h in AKI infants

Ampicillin

GA ≤ 34 weeks

≤ 7 days: 100 mg/kg/day div q12hr
8 – 28 days: 150 mg/kg/day div q12h
≥ 29 days: 200 mg/kg/day div q6h (max 8 g/day)

GA >34 weeks

≤ 7 days: 150 mg/kg/day div q8hr
> 7 days: 200 mg/kg/day div q6hr (max 8 g/day)

Meningitis Dosing

≤ 7 days: 200 – 300 mg/kg/day div q8hr
8 – 28 days: 300 mg/kg/day div q6hr
≥ 29 days: 300 – 400 mg/kg/day div q4 – 6 hr (max dose 12 g/day)

Prophylaxis for urinary tract abnormality

30-50 mg/kg/dose PO q 24 h (or use amoxicillin)
Remember, even 200 mg/kg is a "meningitic dose;" avoid the use of the term "septic dose."

cefepime

GA <36 weeks (≤ 2 kg):

≤28 days: 30 mg/kg/dose IV q12hr
≥ 29 days: 50 mg/kg/dose IV q8hr

GA ≥ 36 weeks (> 2 kg):

≤28 days: 50 mg/kg/dose IV q12hr
≥ 29 days: 50 mg/kg/dose IV q8hr

ceftazidime

GA < 32 weeks

< 14 days: 100 mg/kg/day div q12hr
≥ 14 days: 150 mg/kg/day div q8hr

GA ≥ 32 weeks

≤ 7 days: 100 mg/kg/day div q12hr
> 7 days: 150 mg/kg/day div q8hr

Meningitis

≤ 7 days: 100 -150 mg/kg/day div q8-12hr
> 7 days: 150 mg/kg/day div q8hr

Gentamicin

GA ≤ 29 weeks

≤ 14 days: 5 mg/kg/dose q48hr
15 – 28 days: 5 mg/kg/dose q36hr
≥ 29 days: 5 mg/kg/dose q24hr

GA 30 – 34 weeks

≤ 14 days: 5 mg/kg/dose q36hr
≥ 15 day: 5 mg/kg/dose q24hr

GA ≥ 35 weeks

≤ 7 days: 4 mg/kg/dose q24hr
≥ 8 days: 5 mg/kg/dose q24hr

HIE/Cooling

5 mg/kg/dose q36hr

GENTAMICIN LEVELS

Peak:

5-10 microgram/mL is acceptable.

Trough:

After the second dose for most infants being treated more than 48 h
After 24 h for infants with severe infections, asphyxia, PDA, or renal failure.
If a 24-hour trough is done, choose the next dosing interval as follows:
- 24-Hour Trough Dosing Interval:
- < 1: q24h
- 1.1-2.3: q36h
- 2.4-3.2: q48h
- > 3: check level before each dose
For gentamicin toxicity, give ticarcillin (deactivates gentamicin)

metronidazole

CGA ≤ 34 weeks

7.5 mg/kg/dose q12hr

CGA 34 – 40 weeks

7.5 mg/kg/dose q8hr

CGA > 40 weeks

10 mg/kg/dose q8hr

nafcillin