ICN/NICU Empiric Antimicrobial Guidance for Select Neonatal Infections [PEDS]

Criteria & Principles

Please see the attached for empiric antimicrobial guidance for select neonatal infections.

These antimicrobial recommendations are provided as general guidance for therapy with a goal of assisting with empiric agent selection based on the most common pathogens and local resistance patterns while minimizing unintended consequences for the patient. Antibiotic administration in neonates has been associated with alterations in the gut microbiome and increased risk of childhood diseases (i.e. wheezing, obesity, food allergy, and inflammatory bowel diseases).

• Cultures should be obtained from the appropriate sources prior to initiation of antimicrobial therapy, EXCEPT when this will cause a delay in treatment that will harm the patient.
• Previous culture results and the patient’s antimicrobial history should be reviewed prior to initiation of therapy.
• Culture and other laboratory test results should be used to guide definitive therapy.
• Always consider antimicrobials may NOT be necessary or medication selectionsmay need to be modified, depending on the particular medical situations.
• Patient specific factors should influence selection decisions.
• Pediatric infectious diseases consultation should be considered in complicated or unusual cases or cases with growth of multidrug resistant organisms.