India Antibiotic Guideline For Neonatal Infections
In 2016 National Centre For Disease, Directorate General of Health Services, Ministry of Health & Family Welfare, Government of India came out with National Treatment Guidelines for Antimicrobial Use in Infectious Diseases.
Following are major recommendationw
Neonatal Infections :
a. SEPTICEMIA OR PNEUMONIA
1. In asymptomatic babies at high risk of sepsis eg. presence of foul smelling liquor or two or more risk factors listed below warrants the initiation of antibiotic therapy.
Risk factors for Early onset sepsis are :
(a) Maternal fever (Temperature > 380C) before delivery or during labor
(b) Membranes ruptured for more than 24 hours before delivery.
(c) More than three vaginal examinations during labor.
(d) Low birth weight (<2500 gms) or preterm babies.
(e) Prolonged and difficult delivery with instrumentation. 40
(f) Perinatal asphyxia. (Apgar < 4 at 1 min of age) (g) Meconium stained liquor.
2. A sepsis screen should be done in such infants. If two sepsis screens (NNF protocols) done at 12 hours interval or a single sepsis screen is negative and infant remains asymptomatic at 48 -72 hours, the antibiotics may be discontinued.
| Antibiotic | Each dose | Frequency < 7 days > 7 days | Route | Duration(Days) |
| Inj. Ampicillin And Inj. Gentamicin | 50 mg/kg/dose 5-7.5 mg/kg/dose | 12 hrly 8hrly 24 hrly 24hrly | IV IV | 7-10 7-10 |
- In cases with severe sepsis (Sclerema/ Shock / suspicion of meningitis) Inj Cefotaxime 200 mg/kg/day IV in 4 div doses) + Amikacin (15mg/kg/d) is recommended
- If sepsis is suspected to be health care associated or if there is no response in 48-72 hours of initial therapy or if there is documented resistance then change to injection Piperacillin- Tazobactam (200-300 mg/kg/day IV in 3-4 div doses) and Amikacin.
- Vancomycin can be added to the regime if staphylococcus is suspected.
b. NEONATAL MENINGITIS
| Antibiotic | Dose | Frequency < 7 days > 7 days | Route | Duration (week) | |
| First Line | Inj. Ampicillin and Inj. Gentamicin | 100 mg/kg/ dose 5-7.5 mg/kg/d | 12 hrly 8 hrly 5 mg/kg/d 7.5 mg/kg/d 24 hrly 24hrly | IV IV | 3 3 |
| Second Line | Inj. Cefotaxime and Inj. Gentamicin | 50 mg/kg/dose 5-7.5 mg/kg/dose | 12 hrly 8 hrly 5 mg/kg/d 7.5mg/kg/d 24 hrly 24hrly | IV IV | 3 3 |
You can read the full Guideline by clicking on the following link :
http://www.ncdc.gov.in/writereaddata/linkimages/AMR_guideline7001495889.pdf
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