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Isolates reported as 'I' (susceptible increased exposure) - dosing schedules for neonates and children

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Abstract

Antibiotic dosing guidelines: Treatment of isolates reported as ‘I’ – dosing schedules for neonates and children.

Purpose and Scope:
The purpose of this guideline is to provide antibiotic dosing guidance for use in neonates and children where isolates are reported as ‘I’ on microbiology reports, or where advised by the Microbiology or Infectious Diseases Teams. A susceptibility category of ‘I’ indicates that a specific dosing schedule is required in order for the antibiotic to effectively treat the infecting organism.

The scope of this guidance encompasses the management of neonates and children treated in NHS Greater Glasgow and Clyde. The doses advised in this guidance are relevant only in certain ‘bug-drug’ combinations and should be used ONLY where a susceptibility category of ‘I’ has been assigned, or where specifically recommended by a specialist in infection management.

The doses in the guidance may not be applicable to the management of meningitis. Clinical breakpoints for meningitis may differ from breakpoints for non-meningitic conditions – it must not be assumed that these breakpoints and susceptibility reports are interchangeable. Contact Microbiology for further advice.

The doses advised in this guidance are appropriate for patients with normal renal and hepatic function. Where there is known or suspected renal or hepatic impairment a risk vs benefit decision should be made, taking in to account the increased exposure required to treat the organism effectively.

Editorial Information

Last reviewed: 16 November 2021

Next review: 16 May 2022

Author(s): Susan Kafka

Version: 1

Approved By: Antimicrobial Utilisation Committee

Document Id: 944