Neonatal Pocket Manual
Drug Dosage Calculation & AdministrationNeonatal Procedure GuidelinesNeonatal Screening Guidelines
Department 0f NeonatologyInstitute of Advanced Paediatrics
www.relainstitute.com
DR. RELA INSTITUTE & MEDICAL CENTREAn International Medical Facility
Silverman-Anderson Score
Score 0 Score 1 Score 2 Feature
Chest Movement Equal
None
Respiratory Lag Seesaw Respiration
IntercostalRetraction Minimal Marked
Xiphoid Retraction None Minimal
Minimal
Audible with stethoscope
Audible w/ostethoscope
Marked
Nasal Flaring None
None
Marked
Expiratory Grunt
Total Score of 4-6Moderate Distress - NIV
Total Score of 7-10Severe Distress - Ventilation
Endotracheal Intubation ET Size SelectionPre Medication
For Planned IntubationWt in
KgGest
WeeksET
SizeFix@ Lip
Atropine 0.1 mg16 kappa < 1
1 - 2
2 - 3
> 3
28 - 34 3
< 28 2.5 6 - 7
Midazolam 0.1 mg/kg (10 x Wt) Kappa 7 - 8
Fentanyl 1 mcg/kg1ml+9ml, (20 x Wt) Kappa 34 - 38 3.5 8 - 9
Rocuronium 1 mg/kg(10 x Wt) Kappa > 38 3.5 9 - 10
NIV - Non Invasive Ventilation
1
Respiratory Distress Scoring
SurfactantProduct Type
Bovine 5 ml/kg 27 mg/ml 3 ml / 5 mlDose Phospholipid Vial
Neosurf
Survanta Bovine 4 ml/kg 25 mg/ml 4 ml / 8 ml Curosurf Porcine 2.5 ml/kg 80 mg/ml 1.5 ml / 3 ml
Infasurf Calf Lung 3 ml/kg 35 mg/ml 3 ml
Exosurf Synthetic 4 ml/kg 25 mg/ml 4 ml / 8 ml
INSURE Criteria
Preterm ≥ 30 weeksBirth Wt. ≥ 1.2 kgSpontaneous Respiration PresentModerate to Severe HMD on CXRFiO2 ³ 40% / CPAP (PEEP - 6 , Fi02 ≥, 30%) with Sp02 <90 % Good Perfusion, CRT < 3 Sec, No Inotrope Requirement
Intubate Give Surfactant Extubate to CPAP
Switch from CPAP to Intubation, Consider 2nd Surfactant
Continuing Retractions / Grunt on CPAP for > 6 hours Recurrent Apneas on CPAPRR ≥ 80/min or increasingCPAP > 7 cm H2OFiO2 requirement >60%PaCO2 > 55, Poor respiratory effortsSpO2 < 85% / PaO2 < 50 on CPAP > 6 cm H2O & FiO2 > 50%
2
Important Calculations
Line Insertion Depth Tip Position UAC (3 x Wt in Kg) + 9 cm T6 - T9
1 cm above DiaphragmUVC High: (1.5 x Wt in Kg) + 5.5 cm
UVC Low: Wt in Kg + 3 cm L3 - L4
NG Distance(cm) Xiphoid process to ear lobe to tip of nose
IV ProtienAminoven 10%
1 gm/kg/day to 4 gm/kg/day
(10 x __ gm/kg/day x Wt in Kg) ÷ 24 = ___ ml/hr
IV LipidIntralipid 20%
1 gm/kg/day to 3 gm/kg/day
(5 x __ gm/kg/day x Wt in Kg) ÷ 24 = ___ ml/hr
GIR mg/kg/min
%Dextrose x 10 x IV Rate in ml/hr60 x Wt in Kg
OxygenationIndex ( OI )
MAP x FiO2
PaO2
OI > 15 Need for HFOVOI > 20 Need for iNO
AaDO2[(FiO2 x 713) - PaCO2] - PaO2, FiO2 in Decimal
AaDO2 < 200 = Normal, > 400 = ALI*, > 600 = ARDS
a / ARatio
PaO2
(FiO2 x 713) - PaCO2
0.6 - 0.9 = Normal< 0.4 =ALI*, < 0.2=ARDS
*ALI: Acute Lung Injury
Blood Transfusion GuidelinesHb < 12 gm/dl
PCV < 35Severe Respiratory DistressRequiring High Ventilatory Pressures
Hb < 10 gm/dlPCV < 30
Ventilatory RequirementHypovolemic ShockSymptomatic PDABPD with FiO2 > 30% Pre Surgery
3
Hb < 8.5 gm/dlPCV < 25
Preterm < 2 week oldPoor FeedingPoor Weight Gain: < 10 gm/kg/day for > 3 daysSignificant Apnea >8 in 24 Hr / >2 req Bag & MaskPersistent Tachycardia: HR > 170 bpmPersistent Tachypnea: RR > 70 / min
Hb < 7 gm/dlPCV < 20
Transfuse regardless
PCV Transfusion: 15 ml/kg/dose over 4 - 5 Hours Mid-transfusion Inj Lasix 1 mg/kg (Decide Clinically) Keep NBM* - 2 hours
before and 6 hours after Transfusion
Platelet Transfusion Guidelines
Plt < 20000 Transfuse regardless
Plt < 40000 Active Bleeding 24 Hr Pre surgery
Hypotension 3 Days Post SurgerySeizure last 72 HrInotrope Need
Culture Positive SepsisDIC
Rising CRP / TC On Indomethacin / Brufen
Platelet showing Downward Trend
Wt < 1.2 kg / GA < 32 wks with Probable Sepsis
Clinical deterioration last 48 Hr - Suspected Sepsis
Platelet Transfusion: 15 ml/kg, Over 20-30 min, No Lasix/No NBM (Nil By Mothu)
FFP 15 ml/kg over 1 hr, No NBMFor DIC, Coagulation Defects, Severe Sepsis
15 ml/kg over 1 hr, No NBM
For DIC, Coagulation Defects, Severe Sepsis
4
*NBM: Nil By Mouth
Infusion in 20 ml Syringe
Dose @ 1ml/hr____ ml in 20 ml
10 mcg/kg/min
20 mcg/kg/min
10 mcg/kg/min
20 mcg/kg/min
0.05 mcg/kg/min
0.1 mcg/kg/min
0.5 mcg/kg/min
0.05 mcg/kg/min
0.1 mcg/kg/min
Load - 0.05 mg/kg
0.33 mcg/kg/min
Load - 0.4 mg/kg
0.067 mg/kg/hr
0.06 mg/kg/hr
0.125 mg/kg/hr
1 mcg/kg/hr
2 mcg/kg/hr
Medication
Dopamine
40 mg/ml
Dobutamine
50 mg/ml
Adrenaline
1 mg/ml
Norad
1 mg/ml
Milrinone
1 mg/ml
Sildenfil
0.8 mg/ml
Lasix
10 mg/ml
Fentanyl
50 mcg/ml
Morphine
10 mg/ml
1 ml Morphine + 9 ml NS = 1 mg/ml
10 mcg/kg/hr
0.3 x Wt
0.6 x Wt
0.24 x Wt
0.48 x Wt
0.06 x Wt
0.12 x Wt
0.6 x Wt
0.06 x Wt
0.12 x Wt
0.05 x Wt
0.4 x Wt
0.5 x Wt
1.7 x Wt
0.12 x Wt
0.25 x Wt
0.4 x Wt
0.8 x Wt
0.2 x Wt
5
Infusion in 50 ml Syringe
Dose @ 1ml/hr____ ml in
20 ml
50 ng/kg/min
100 ng/kg/min
0.0005 U/kg/min
Start @ 0.6 ml/hr = 0.0003 U/kg/min
Medication
PGE1
500 mcg/ml
Vasopressin
20 U/ml
0.3 x Wt
0.6 x Wt
0.075 x Wt
6
IV AnticonvulsantMidazolam
1 mg/ml
0.1 mg/kg/dose
Lorazepam
2 mg/ml
0.1 mg/kg/dose
Phenobarbitone
200 mg/ml
Load - 20 mg/kg
For Maintenance: 1 ml Phenobarb + 9 ml NS
2.5 mg/kg/dose
Load - 15 mg/kgFosphenytoin
50 mg PE/ml 2.5 mg/kg/dose
Oral AnticonvulsantGardenal
20mg/5ml
2.5 mg/kg/dose
3 mg/kg/dose
Eptoin
30mg/5ml
2.5 mg/kg/dose
3 mg/kg/dose
Scoring System for Starting Antibiotic
No Criteria Score
Intrapartum Vaginal Examination > 3Clinical Chorioamnionitis
PROM > 12 HoursMaternal Fever / Sepsis - Last 7 days
Home Delivery
Preterm / Premature onset of Labour
Outside NICU Stay > 24 hoursMale GenderBirth Weight < 1.2 kgGestation < 30 weeks
Total Score: 0 - 10 Total Score ≥ 10
No Antibiotics CBC, CRP at Admission & 48 Hr
Monitor Clinically
Sent CBC, CRPSend Blood Culture
Start First Line Antibiotic
Prophylactic Antifungal in Neonates
CriteriaBW < 1.2 kg, GA < 32 weeksTPN > 7 Days
Invasive Lines > 7 DaysMechanical Ventilation > 7 DaysBroad Spectrum Antibiotics > 7 DaysTill 4 weeks or risk factor +
Route: IV / OralFrequency: Twice a week
Dose: 6 mg/kg/dose
7
Caloric CalculationsEBM - Term
Pre NanNan 1
Lactogen
EBM-Preterm0.68 kcal/ml0.67 kcal/ml0.79 kcal/ml0.67 kcal/ml
0.67 kcal/ml
0.88 kcal/ml
10% D5% D
Aminoven 10%Lipid 20%
HMF
MCT Oil
0.34 kcal/ml
0.17 kcal/ml
0.4 kcal/ml
2 kcal/ml7.5kcal/Sachet0.39 kcal/dropLactodex LBW
Protocols forUSG Brain
< 1 kg< 30 week
1 - 1.5 kg30 - 34 week
> 1.5 kg> 34 week
Day 0 - 3
Day 3 - 5
Day 7 - 10Day 28
If SickHigh Risk Pt
High Risk PtHigh Risk Pt
Repeat USG Brain to be planned as per the findings of the 1st Scan
RDS,Sepsis,Asphyxia,HIE,Pneumothorax,Base Deficit>10,Shock requiring Inotropes, , Maternal Pre-Eclampsia
High RiskPatient
8
Guidelines for ROP Screening / Eye Check< 28 week
≥28 week
Term
High Risk
At Corrected 31 weeks
At Postnatal 4 weeks
If Risk Factor - At Postnatal 2 weeks/Before DischargeVentilation > 72 Hr, Prolonged O2 need, RDS,Sepsis,CHD,
Shock requiring Inotrope, Blood Transfusion,ExchangeTransfusion
NICU IV Fluid Protocol
< 1 kg
100 ml/kg/day
110 ml/kg/day
120 ml/kg/day 100 ml/kg/day 80 ml/kg/day
500ml 10% Dextrose + 10ml* Calcium Gluconate
500ml 10% Dextrose + 10ml* Calcium Gluconate
500ml 0.45 DNS + 5ml MVI
80 ml/kg/day
90 ml/kg/day
60 ml/kg/day
70 ml/kg/day
1 - 1.5 kg > 1.5 kg
Day 1
Day 2
Day 3
Dextrose Conc. To be changed according to RBS monitoring
* Add 20ml Calcium to 500ml in c/o Birth Asphyxia, IDM, IUGR, LGA
NICU Blood Investigation Protocol - RoutineTime < 1 kg 1 - 1.5 kg > 1.5 kg
0 Hr Admission
CBC, CRP Blood Group
G6PD (in Male)ABG (Resp Case)
CBC, CRPBlood Group
G6PD (in Male)ABG (Resp Case)
CBC, CRPBlood Group
G6PD (in Male)ABG (Resp Case)
Blood Culture in High Risk Group(See Antibiotic Scoring System)
24 HrSOS
Na, K, iCa,Creat, S.Bil
Na, K, iCa,Creat, S.Bil
48 HrCBC, CRPNa,K, iCa,
Creat, S.Bil
CBC, CRPNa, K, iCa,
Creat
CBC, CRPNa, K, iCa,
Creat
9
@ FullFeeds
@ 4Weeks
iCa, Po4Alk Phosphatase
CBCNa, K
iCa, Po4 Alk Phosphatase
CBCNa, K
CBCNa, K
Arterial Blood Gas Values - Normogram
Suggested Actions following ABG Report
ABGpH
PCO2
Po2
ABG Result
PCO2 - OK/LowPO2 - Low
PCO2 - OK/Low
PO2 - OK/High
PCO2 - OK/HighPO2 - Low
PCO2 - OK/HighPO2 - High
Atelectasis withResultant Low TV
Inadequate minuteventilation with at least
adequate FRC
PCO2 - OK/Low
PO2 - OK/High
Atelectasis withV/A Mismatch
PEEP
Possible Reason Suggested Changes
45-65 50-70 80-100 60-80
40-50 40-60 35-45 45-65
< 30 wk>7.25
30 - 36 wk
>7.25
Term
7.35-7.45
BPD
7.50-7.60
PIPPIP & PEEP
Rate
Rate
PIP & PEEPPIP
PEEP
PIP
10
Acetaminophen 10 - 15 mg/kg/dose IV/PO 6 - 8 Hrly
Acetazolamide
Acetylcysteine
Adenosine
Adrenaline
Alpostin (PGE1)Albumin
Aminophylline
Amiodarone
AtropineBudesonide
Caffiene Citrate
Calcium - OralCarnitineChloral Hydrate
Calcium Gluconate 20%
Metabolic Alkalosis5 mg/kg/dose PO 24 Hrly x 3 days
TPN induced cholecystitis100 mg/kg/day IV InfusionNebulisation1 - 2 ml of 20% Sol, 1:1 Dil, 6 - 8 HrlySVT: 0.05 mg/kg/dose Rapid IV Every 2min, increment of 0.05 mg/kg, 3 dosesResuscitation: 1:10000 SolutionIV: 0.1 - 0.3 ml/kg, ET: 0.3 - 1 ml/kgNebulisation (1:1000): 0.5 ml/kg + 3ml NS0.01 - 0.1 mcg/kg/min IV Infusion
50 - 100 ng/kg/min IV Infusion0.5 - 1 gm/kg IV over 2 HrLoad: 5 - 6 mg/kg IV
nM : 1 - 2 mg/kg/dose IV 6 - 8 HrlyLoad: 5 mg/kg IV over 1 Hr
nM : 5 - 15 mcg/kg/min IV Infusion0.02 mg/kg/dose IV, Min 0.1 mg, Max 0.6 mgNebulisation: 0.25 - 0.5 mg + 3 ml NS
Load: 20 mg/kg IV®M : 5 - 10 mg/kg IV/PO 24 Hrly
1 - 2 ml/kg/dose, 1:1 Dil, 6 - 8 Hrly100 - 125 mg/kg/dose PO 12 Hrly50 mg/kg/dose IV/PO 12 Hrly
25 - 50 mg/kg/dose PO
11
DexamethasoneDextrose 10%Digoxin
nM doses 24 Hrly
DobutamineDomperidoneDopamineDornase Alfa (Mesna)
Doxapram
Enoxaparin
Erythromycin
Erythropoietin
Fentanyl
Flecainide
Fludrocortisone
FosPhenytoin
Furosemide (Lasix)
50 mg PE/ml
5 - 20 mcg/kg/min IV Infusion0.3 mg/kg/dose PO 6 - 8 Hrly5 - 20 mcg/kg/min IV InfusionIntratracheal: 0.2 ml/kgNebulisation: 1.25 - 2.5 ml, 1:1 Dil, 12 - 24 HrlyLoad: 2.5 - 3 mg/kg IV over 1 Hr
nM : 1 - 2.5 mg/kg/Hr IV InfusionTreatment: 1.75 mg/kg/dose SC 12 Hrly
Prophylaxis: 0.75 mg/kg/dose SC 12 Hrly
Prokinetic: 5 mg/kg/dose 6 Hrly, 5 days
200 - 400 U/kg/dose IV/SC 3 times a week
Bolus: 1 - 2 mcg/kg IV
1 - 2 mcg/kg/Hr IV Infusion
2 - 4 mg/kg/dose PO 12 Hrly
CAH: 0.05 - 0.3 mg PO 24 Hrly
CAH: 0.05 - 0.3 mg PO 24 HrlynM : 2 - 3 mg PE/kg/dose IV12 Hrly
Bolus: 0.5 - 2 mg/kg IV/PO 8 - 12 Hrly
0.06 - 0.25 mg/kg/Hr IV Infusion
mcg/kgLOAD IV
nM IV 4 5 4PO
PO 6 6 5
20 25 40
≤29 wk15 20 30
30-36 wk ≥37 wk
Extubation: 0.15 mg/kg/dose IV 8 Hrly, 4 dosesHypoglycemia: 2 ml/kg IV
12
Hypoglycemia: 0.02 - 0.03 mg/kg/dose IV/SC0.5 ml/kg/dose, 1:1 Dil, PR 12 - 24 Hrly4 - 10 mcg/kg/dose IV 4 - 8 HrlyIV Patency: 0.5 - 1 U/ml of IVFThrombosis: Load: 75U/kg over 10 min
nM : 28 U/kg/Hr IV Infusion1 - 2 mg/kg/dose PO 12 Hrly, with foodShock: 2 mg/kg/dose IV 6 - 8 HourlyStress: 0.5 - 1 mg/kg/dose IV/PO 12 HrlyPDA: 10 - 5 - 5 mg/kg/dose IV/PO 24 HrlyPDA: ___ mg/kg/dose IV 12 - 24 Hrly, Over 1 Hr
IVH Prophylaxis: 0.1 mg/kg/dose IV24 Hrly x 3DBolus: 0.05 U/kg IV/SC0.05 - 0.2 U/kg/Hr IV InfusionNebulisation: 0.25 mg + 3ml NS 6 - 12 Hrly2 - 3 mg/kg/dose PO 12 hrly, Elemental Iron0.05 - 2 mcg/kg/min IV Infusion1 gm/kg/day IV over 4 - 5 Hr, 3 - 5 days1 - 2 gm/kg/dose PO/PR 4 - 6 Hrly1 - 2 mg/kg/dose IV2 Drops Each Eye 6 Hrly, 3 days10 mg/kg/dose IV/PO 12 Hrly10 mcg/kg/dose PO 12 Hrly
< 48 Hr 0.2 0.1 0.10.2 0.2 0.20.2 0.25 0.25
2 - 7 D> 7 D
GlucagonGlycerineGlycopyrrolateHeparin
HydrochlorthiazideHydrochlorthiazide
IbuprofenIndomethacin
Insulin
Iron - Oral
IVIGKayexelate (K Bind)Ketamine
LevetiracetamLevothyroxine
Ketorolac (Eye Drops)
Isoproterenol
Ipratropium Bromide
13
Bolus: 1 - 2 mg/kg/dose IV over 2 min20 - 50 mcg/kg/min IV Infusion0.05 - 0.1 mg/kg/dose IV25 - 50 mg/kg/dose IV over 1 Hr, 4 - 6 Hrly0.1 - 0.2 mg/kg/dose IV/PO 8 - 12 Hrly1 - 2 mg/kg/dose IV/PO 12 HrlyBolus: 0.1 mg/kg IV0.2 - 1 mcg/kg/min IV InfusionLoad: 0.05 mg/kg IV over 30 min
nM : 0.33 - 0.75 mcg/kg/minBolus: 0.05 - 0.1 mg/kg IV10 - 20 mcg/kg/Hr IV Infusion0.1 mg/kg/dose IV, Repeat 2 - 3 min0.01 - 0.5 mcg/kg/min IV InfusionChylothorax: 1 - 4 mcg/kg/Hr IV Infusion0.5 - 1.5 mg/kg/dose IV 24 Hrly0.1 mg/kg/dose IV/PO 8 - 12 Hrly1 - 1.5 mg/kg/dose IV 24 HrlyLoad: 20 mg/kg IV
nM : 2.5 - 3 mg/kg/dose IV/PO 12 HrlyJaundice: 2 - 3 mg/kg/dose PO 8 - 12 HrlyLoad: 15 mg/kg IV
nM : 2 - 3 mg/kg/dose IV/PO 12 Hrly<2kg: 0.5 mg, > 2kg: 1 mg IV/IMArrythemia: 0.1 mg/kg/dose IV Push1 mg/kg/dose IV 12 Hrly1 mg/kg/dose IV
Lidocaine
LorazepamMagnesium SulfateMetoclopramideMetoprololMidazolam
Milrinone
Morphine
NaloxoneNoradrenalineOctreotideOmeprazoleOndensatronePantoprazolePhenobarbitone
Phenobarbitone
Phytonadione (Vit K1)PropranololRanitidineRocuronium
14
Salbutamol Nebulisation: 0.03 ml/kg + 3ml NS 6 - 8 HrlyLoad: 0.4 mg/kg IV over 3 Hr0.067 mg/kg/Hr IV InfusionOral: 0.5 - 2 mg/kg/dose 6 - 8 Hrly1 - 2 mEq/kg/dose IV, 1:1 Dil, Over 1 Hr1 - 2 mg/kg/dose PO 12 Hrly1 - 2 mg/kg/dose IV32 - 37 wk: 1 ml PO 2 min before procedure> 37 Wk: 2 ml PO 2 min before procedure1 Drop each eye, Every 5 min, 3 timesCholestasis: 10 - 15 mg/kg/dose PO 8 Hrly0.0001 - 0.0003 U/kg/min IV Infusion0.1 mg/kg IV5000 IU, IM, 3 days a week, 12 doses400 - 1000 IU PO 24 Hrly25 IU PO 24 Hrly0.1 - 0.2 mg/kg/dose PO 24 Hrly
Sildenafil
Sodium BicarbonateSpironolactoneSuccinyl CholineSucrose 24%
Tropicamide 0.5%UrsodiolVasopressinVecuroniumVitamin AVitamin D3Vitamin E
Warfarin
Oxygen
Adrenaline
Dextrose 10%
NS
NICU RESUSCITATION DRUGS
1:10000, 0.1 ml/kg IV, 0.3 ml/kg ET
2 ml/kg IV
10 ml/kg
15
Congenital Hypothyroidism
G6PD deficiencyCongenital Adrenal Hyperplasia phenylketonuria
Galactosemia
Cystic Fibrosis
NEONATAL SCREENING AT 48 HRS OF LIFE (HEEL PRICK)
ANTIBIOTICSIV 24 HrlyAmikacin≤ 29 wk
30 - 33 wk
50 mg/kg/dose IV
10 mg/kg/dose IV/PO 24 Hrly
50 mg/kg/dose IVSepsis - 12 Hrly, Meningitis - 8 Hrly
50 mg/kg/dose IV 8 HrlyLoad: 20 mg/kg/dose IV over 1 HrAfter 24 Hrs, 5 mg/kg/dose IV 6 Hrly10 - 15 mg/kg/dose IV 12 Hrly
50 mg/kg/dose IVCefotaxime
Ceftriaxone
CefuroximeChloramphenicol
Ciprofloxacin
Azithromycin
Ampicillin≥ 34 wk
0 - 28 D> 28 D
0 - 14 D> 14 D0 - 7 D> 7 D
0 - 28 D> 28 D
0 - 14 D> 14 D0 - 7 D> 7 D
≤ 29 wk
30 - 36 wk
≥ 37 wk
≤ 29 wk
30 - 36 wk
≥ 37 wk
8 Hrly
8 Hrly
12 Hrly
12 Hrly
8 Hrly12 Hrly
12 Hrly
8 Hrly
8 Hrly12 Hrly
8 Hrly12 Hrly
15 mg/kg 15 mg/kg 15 mg/kg10 mg/kg 15 mg/kg 15 mg/kg7.5 mg/kg 10 mg/kg 15 mg/kg
0 - 7 D 8 - 28 D > 28 D
16
Metronidazole Load: 15 mg/kg/dose IV over 1 HrAfter 24 Hrs, 7.5 mg/kg/dose IV
0 - 28 D
> 28 D
0 - 14 D
> 14 D
0 - 7 D
> 7 D
0 - 28 D
> 28 D
30 - 36 wk 0 - 14 D
> 14 D
0 - 7 D
> 7 D
≥ 37 wk
≤ 29 wk
≥ 37 wk
5 mg/kg/dose IV 24 Hrly
5 mg/kg/dose IV 24 Hrly
Load: 16 mg/kg/dose IV over 1 Hr
After 24 Hrs, 8 mg/kg/dose IV 12 Hrly
Load: 2 mg/kg/dose IV over 1 HrLoad: 2 mg/kg/dose IV over 1 Hr
After 24 Hrs, 1 mg/kg/dose IV 12 Hrly
Sepsis: 10 mg/kg/dose IV
Meningitis: 15 mg/kg/dose IV
< 37 wk
≥ 37 wk
0 - 14 D 12 Hrly
0 - 7 D 12 Hrly
> 7 D 8 Hrly
> 14 D 8 Hrly
100 mg/kg/dose IV, over 1 HrTazobactumTazobactumPiperacillin
Polymyxin BTiecoplanin
Tigecycline
Vancomycin
Netilmicin
24 Hrly
12 Hrly
12 Hrly
12 Hrly
12 Hrly
8 Hrly
8 Hrly
8 Hrly
12 Hrly
30 - 36 wk 24 Hrly
24 Hrly
12 Hrly
≤ 29 wk
17
ClarithromycinClindamycin
7.5 mg/kg/dose IV/PO 12 Hrly
Load: 10 mg/kg/dose IV (1 MU = 80 mg)
TMP: 4 - 6 mg/kg/dose IV/PO 12 HrlyIV 24 Hrly Over 1 Hr
Non CNS Infection: 20 - 25 mg/kg/dose IV 12 HrlyLevofloxLinezolidMeropenem
10 mg/kg/dose IV 12 Hrly10 mg/kg/dose IV/PO, 0 - 7 D: 12 Hrly, > 7 D: 8 HrlySepsis: 20 mg/kg/dose IV
Meningitis: 40 mg/kg/dose IV 8 Hrly
Imipenem
After 24 Hrs, 5 mg/kg/dose IV 12 HrlyColistin
CotrimoxazoleGentamycin
5 - 7.5 mg/kg/dose IV0 - 28 D> 28 D
0 - 14 D
0 - 7 D> 7 D
0 - 7 D> 7 D
0 - 7 D> 7 D
All
0 - 14 D
0 - 7> 7 D
12 Hrly≤ 32 wk
> 14 8 Hrly
8 Hrly
< 32 wk
5 mg/kg5 mg/kg
12 Hrly
4 mg/kg5 mg/kg4 mg/kg
≤ 29 wk
30 - 34 wk
≥ 35 wk
> 14 D 8 Hrly12 Hrly8 Hrly
12 Hrly
12 Hrly8 Hrly
≤ 29 wk
30 - 36 wk
≥ 37 wk
18
ANTIFUNGAL MEDICATION1 - 1.5 mg/kg/dose IV 24 HrlyIV Infusion over 2 - 3 Hr2.5 - 5 mg/kg/dose IV 24 HrlyIV Infusion over 2 - 3 Hr
3 - 5 mg/kg/dose IV 24 HrlyIV Infusion over 2 - 3 Hr2 mg/kg/dose IV 24 HrlyIV Infusion over 2 HrProphylaxis: 6 mg/kg/dose IV/PO Twice a wkTreatment: 12 mg/kg/dose IV/PO 24 Hrly
Amphotericin BConventionalAmphotericin BLipid ComplexAmphotericin BLiposomalCaspofungin
Fluconazole
DISCLAIMERDoses of all the medications mentioned here are as per the
international guidelines for Neonates, as at March 2014.
Doses of all Antimicrobial Medications are in consensus withPaediatric Infectious Disease Specialist, as at March 2014.
These are Neonatal doses, may not be translated in the similarmanner for the Paediatric age group.
Confirm with Neonatologist, in case of doubt
Herpes Simplex Encephalitis> 32 Weeks, > 1.2 kg20 mg/kg/dose IV 8 HrlyCongenital CMV 6 mg/kg/dose IV Over 1 Hr, 12 Hrly, for 6 weeksPerinatal HIV2 mg/kg PO, Single DoseWithin 72 Hrs of BirthPerinatal HIV2 mg/kg/dose PO< 35 Wk: 8 Hrly, ≥ 35 Wk: 6 Hrly
Acyclovir
Gancyclovir
Nevirapine
Zidovudine
19
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INSTITUTE OF ADVANCED PAEDIATRICS
No. 7, CLC Works Road, Chromepet, Chennai - 600 044.
Ph: 044-6666 7777
www.relainstitute.com
DR. RELA INSTITUTE & MEDICAL CENTRE
24 Hr Emergency 044-6666 7788
Neonatal Emergency,Call: 63742 14191
