Premature infant with new late-onset sepsis.
Can U answer :
1.What therapeutic alternatives are available for the empiric treatment of neonatal sepsis?
2.Was the empiric gentamicin dose appropriate for this patient? If not, recommend an alternative dose and frequency and provide the rationale for
your choice.?
3.What therapeutic alternatives are available for the treatment of S. maltophilia in this neonate?
4.What therapeutic alternatives are available for the treatment of MRSA bacteremia in this neonate?
Answers
Answer:
1. The World Health Organization recommends ampicillin (or penicillin; cloxacillin if staphylococcal infection is suspected) plus gentamicin for empiric treatment of neonates with suspected clinical sepsis or meningitis.
2. ..........
3. maltophilia infections is not possible, there may be other effective alternative treatments that can be used, namely ciprofloxacin as monotherapy or in combination with other antibiotics, or ceftazidime/ceftriaxone and ticarcillin/clavulanate alone or in combination with other agents.
4. Infections due to multi-drug resistant HA-MRSA strains should be treated with a combination of parenteral vancomycin plus gentamicin and/or rifampin, but alternatives such as trimethoprim-sulfamethoxazole, linezolid, quinupristin-dalfopristin, or fluoroquinolones could also be considered pending results of .