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. Author manuscript; available in PMC: 2016 Mar 1.
Published in final edited form as: Clin Perinatol. 2014 Dec 6;42(1):29–45. doi: 10.1016/j.clp.2014.10.004

Table 4.

Common antibiotics used to treat neonatal meningitis

Antibiotic (ref) Susceptible Bacteria Notes
Penicillin G (61) GBS Monotherapy acceptable if GBS confirmed by culture and clinical improvement is observed
Ampicillin (2, 6, 62, 63) GBS
L. monocytogenes Enterococcus sp.
17–78% of E. coli isolates resistant
Poor CNS penetration
Requires higher doses for meningitis
Gentamicin (2, 62, 64) E. coli Klebsiella sp.
Enterobacter sp.
Pseudomonas sp.
Citrobacter sp.
Serratia sp.
Poor CNS penetration
Synergistic effect with ampicillin in treatment of L. monocytogenes
Pseudomonas sp. may require combination therapy with a second agent
Requires therapeutic drug monitoring
Cefotaxime (24, 62, 64) E. coli Klebsiella sp.
Enterobacter sp.
Citrobacter sp.
Serratia sp.
Good CNS penetration
Used instead of gentamicin in cases of suspected or confirmed meningitis
Not active against L. monocytogenes or Enterococcus sp.
Meropenem (64, 65) E. coli Klebsiella sp.
Enterobacter sp.
Citrobacter sp.
Serratia sp.
Pseudomonas sp.
Good CNS penetration
Limit use to multidrug resistant organisms (e.g., extended-spectrum beta-lactamase-producing organisms)
Vancomycin (62, 66) Coagulase-negative staphylococci
S. aureus Enterococcus sp.
Variable CNS penetration
Effective against methicillin-resistant S. aureus
Requires therapeutic drug monitoring
Nafcillin (66, 67) Methicillin-sensitive S. aureus Good CNS penetration
Superior to vancomycin for treatment of methicillin-sensitive S. aureus

GA, gestational age (weeks); PNA, postnatal age (days); SCr, serum creatinine (mg/dL).