(Sorry to those on both PED-EM and EMED-L for the cross posting)
A question for the group- In the infant less than 6-8 weeks old, who requires empiric antibiotic coverage for fever without a focus, are you guys still staying away from Ceftriaxone because of the potential complication of biliary sludging? I was trained this way, but don't recall ever seeing the reference for this practice. I have noticed in Rocephin dosing guidelines it states for infants less than 2 months.
Just out of curiosity, what combinations are all of you using?
Amp and Gent, or Amp/sulbactam and Gent?
Amp and Rocephin?
Amp and Cefotaxime?
Of interest possibly, looking at this again, I found a source that gave a number needed to treat (NNT) of 138 to successfully treat one listeria case. That is to say, to make the addition of ampicillin useful, as I understand it. ( http://www.guideline.gov/summary/summary.aspx?doc_id=4130&nbr=3166&string=Pediatric+AND+Fever) I have still been using amp initially in the ED, and plan to continue to do so. How about all of you?
Thanks in advance for your opinions and references.
D. Scott Moore, D.O., M.S.
Staff Emergency Department Physician
South Baldwin Regional Medical Center
Vice-President of Performance Improvement
Emerald Healthcare Group
For more information, send mail to [log in to unmask] with the message: info PED-EM-L
The URL for the PED-EM-L Web Page is: