. 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).