Madelena Drăgan, Mihaela Mihordea *
Conf. univ. dr. Madelena I. Drăgan, Dr. Mihaela Mihordea
Clinica de boli Infecțioase III – Pediatrie – “Colentina”
Universitatea de Medicină și Farmacie “Carol Davila”, București
Abstract
Initial therapy of suspected neonatal meningitis is based on synergistic bactericid combination of ampicillin and an aminoglycoside to assure a broad antimicrobial coverage until the diagnosis is estabilshed with certainty. Group B streptococci are constantly sensitive to penicillin G, which is the drug of choice when the diagnosis is established. The recommendeddosage for newborns in the first week of life is 200.000-250.000 U/kg/day i.v. or i.m. given as 3 doses and for newborns after 1 week of life is 250.000 U/kg/day given as 6 doses. Gentamicin 5-7,5 mg/kg/day given i.v. or i.m. has a synergisitc action with penicillin. Penicillin G is the drug of choice in neonatal meningitis due to group C and G streptococci. Either septicemia or meningitis due to group D streptococci should receive ampicillin 100-200 mg/kg/day given as 3-4 doses plus kanamycin 15-20 mg/kg/day in 2 doses. The therapy of choice of neonatal meningitis due to Listeria monocytogenes is ampicillin, 100-300 mg/kg/day i.v., in 3-4 doses in combination, in severe cases, with gentamicin 7.5 mg/kg/day i.v. in 3 doses. Despite of antibiotherapy and supportive intensive therapy, neonatal meningitis has a high mortality of about 30-50%.