What is the treatment for bacterial meningitis in the first month of life?

Updated: Jul 16, 2019
  • Author: Rodrigo Hasbun, MD, MPH; Chief Editor: Michael Stuart Bronze, MD  more...
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In the first month of life, the most common microorganisms are group B or D streptococci, Enterobacteriaceae (eg, E coli), and L monocytogenes. Primary treatment consists of a combination of ampicillin and cefotaxime. The recommended dosage for cefotaxime is 50 mg/kg IV every 6 hours, up to 12 g/day. Ampicillin dosages are as follows:

  • Age 0-7 days – 50 mg/kg IV every 8 hours

  • Age 8-30 days – 50-100 mg/kg IV every 6 hours

Alternative treatment consists of ampicillin plus gentamicin. Gentamicin dosages are as follows:

  • Age 0-7 days – 2.5 mg/kg IV or intramuscularly (IM) every 12 hours

  • Age 8-30 days – 2.5 mg/kg IV or IM every 8 hours

Most authorities recommend adding acyclovir 10 mg/kg IV every 8 hours for herpes simplex encephalitis.

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