|Condition||Major Pathogens||First Choice Therapy||Alternative Therapy||Comments|
|Necrotizing enterocolitis, definite||
Enteric Gram negatives
AND if perforation, critical illness, or worsening on Ampicillin and Gentamicin, ADD Metronidazole
|Piperacillin-tazobactam (Zosyn) may be used in the setting of impaired renal function or persistent hypotension||
Refer to Neonatal Dosing Guideline for antibiotic doses and intervals
Click here for further guidelines on antibiotic selection and duration of therapy for necrotizing enterocolitis
These are guidelines only and not intended to replace clinical judgment. Modification of therapy may be indicated based on patient comorbidities, previous antibiotic therapy or infection history. Doses provided are usual doses but may require modification based on patient age or comorbid conditions. Refer to Pediatric Antimicrobial Dosing Guideline for further guidance on dosing in children, and Neonatal Dosing Guideline for infants < 1 month of age. Consult a pediatric pharmacist for individualized renal or hepatic dose adjustment. For additional guidance, please contact Pediatric Infectious Diseases (ID) or the Pediatric Antimicrobial Stewardship Program (ASP).