British National Formulary for Children 2015/2016 recommendations for empirical treatment of neonatal and paediatric septicaemia4
| Infection | Antimicrobials |
|---|---|
| Septicaemia in neonate <72 hours old | Benzylpenicillin plus gentamicin |
| If Gram-negative pathogen suspected: add cefotaxime, stop benzylpenicillin if Gram-negative infection confirmed | |
| Septicaemia in neonate >72 hours old | Flucloxacillin plus gentamicin OR amoxicillin plus cefotaxime |
| Suggested duration 7 days | |
| Septicaemia in child 1 month to 18 years, community-acquired | Amoxicillin plus aminoglycoside OR cefotaxime alone |
| If Pseudomonas spp or resistant organisms suspected: use broad-spectrum antipseudomonal β-lactam antibiotic | |
| If anaerobic infection suspected: add metronidazole | |
| If Gram-positive infection suspected: add flucloxacillin OR vancomycin | |
| Suggested duration at least 5 days | |
| Septicaemia in child 1 month to 18 years, hospital-acquired | Broad-spectrum antipseudomonal β-lactam antibiotic, for example: piperacillin/tazobactam, imipenem/cilastin, meropenem |
| If Pseudomonas spp or multiresistant organisms suspected or if severe sepsis: add aminoglycoside | |
| If methicillin-resistant Staphylococcus aureus (MRSA) suspected: add vancomycin | |
| If anaerobic infection suspected: add metronidazole to a broad-spectrum cephalosporin | |
| Suggested duration at least 5 days | |
| Septicaemia in presence of central vascular catheter | Vancomycin |
| If Gram-negative pathogens suspected: add broad-spectrum antipseudomonal β-lactam | |
| Consider line removal | |
| Meningococcal septicaemia | Benzylpenicillin or cefotaxime, if allergic give chloramphenicol |
Potentially to be used interchangeably: ampicillin and amoxicillin, ceftriaxone and cefotaxime, teicoplanin and vancomycin.