Bibliographic information
Recommendation
In young infants aged 0–59 days who are hospitalized with suspected pneumonia, ampicillin IM/IV plus gentamicin IM/IV for at least 7 days is recommended as first-choice antibiotic management.
Recommended in favor
Strong
Certainty of evidence
Very low
Notes and Remarks
Remarks ■ There were no included trials. ■ The GDG recognized that there were also limited data on antibiotic dosing. Based on clinical practice, the GDG considered that the following antibiotic doses should be used: ampicillin IM/IV 50 mg/kg every 12 hours in the first week of life and every 8 hours after the first week of life for a total of at least 7 days plus gentamicin IM/IV 5 mg/kg once a day in the first week of life and 7.5 mg/kg once a day after the first week of life for a total of at least 7 days. ■ The GDG emphasized the importance of adjusting empiric antibiotic therapy during the course of the illness, as is routinely done in many hospitals. This includes targeting individual antibiotic therapy regimens based on microbiological test results, and stopping antibiotic therapy based on validated, clinical and laboratory risk stratification algorithms. ■ The GDG made a strong recommendation despite the lack of trials as they felt strongly about the importance of providing clear guidance for the management of infants with pneumonia. The GDG were able to use their knowledge and experience in best practice clinical management of pneumonia in young infants to make this recommendation by consensus.