Management of Serious Bacterial Infections in Infants Aged 0–59 Days

Publication Date: December 8, 2024
Last Updated: December 10, 2024

Summary of Recommendations

Non-Hospital Settings

In young infants aged 0–59 days, the WHO 7-sign integrated management of childhood illness (IMCI) algorithm is recommended for the identification of infants with possible serious bacterial infection (PSBI) who require further evaluation or treatment. (S, M )
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Young infants aged 0–59 days with the IMCI signs of critical illness should be referred to hospital. If referral is not possible, ampicillin IM/IV plus gentamicin IM/IV for at least 10 days is recommended. (S, VL )
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Young infants aged 0–59 days with the IMCI signs of clinical severe infection should be referred to hospital. If referral is not possible then oral amoxicillin for at least 7 days plus gentamicin IM/IV for at least 7 days is recommended. (S, L )
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If 7 days of gentamicin is not feasible, oral amoxicillin for at least 7 days plus gentamicin IM/IV for 2 days may be considered. (C, L )
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Young infants aged 0–6 days with fast breathing as the only IMCI sign of illness should be referred to hospital. If referral is not possible, oral amoxicillin for at least 7 days is recommended. (S, L )
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Young infants aged 7–59 days with fast breathing as the only IMCI sign of illness should be treated with oral amoxicillin for at least 7 days. These infants can be managed outside hospital or in hospital depending on clinical judgement. (S, VL )
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Hospital Settings

No recommendation was made on diagnostic accuracy of clinical signs of sepsis in young infants aged 0–59 days in hospital settings. (U, U)
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In young infants aged 0–59 days who are hospitalized with suspected sepsis, ampicillin IM/IV plus gentamicin IM/IV for at least 10 days is recommended as first-choice antibiotic management. (S, M )
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In young infants aged 0–59 days who are hospitalized with suspected staphylococcal sepsis, cloxacillin IM/IV plus gentamicin IM/IV for at least 10 days is recommended as first choice antibiotic management. (S, VL )
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In young infants aged 0–59 days who are hospitalized with suspected meningitis, ampicillin, cefotaxime or ceftriaxone IM/IV plus gentamicin IM/IV for at least three weeks is recommended as first-choice antibiotic management. (S, VL )
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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. (S, VL )
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In young infants aged 0–59 days who are hospitalized with suspected staphylococcal pneumonia, cloxacillin IM/IV plus gentamicin IM/IV for at least 7 days is recommended as first choice antibiotic management. (S, VL )
620

Recommendation Grading

Disclaimer

The information in this patient summary should not be used as a substitute for professional medical care or advice. Contact a health care provider if you have questions about your health.

Overview

Title

Management of Serious Bacterial Infections in Infants Aged 0–59 Days

Authoring Organization

World Health Organization

Publication Month/Year

December 8, 2024

Last Updated Month/Year

December 10, 2024

Document Type

Guideline

Country of Publication

Global

Document Objectives

The World Health Organization (WHO) has developed guidelines for the management of infants aged 0-59 days with serious bacterial infections (sepsis, meningitis, and pneumonia) in hospital and also outside hospital if referral is not possible. The guidelines now include recommendations on diagnosis as well as first line empiric antibiotic treatment of the most critically ill infants aged 0-59 days with suspected sepsis, meningitis and pneumonia.

Inclusion Criteria

Male, Female, Infant

Health Care Settings

Ambulatory, Hospital, Outpatient

Intended Users

Nurse, nurse practitioner, physician, physician assistant

Scope

Management

Diseases/Conditions (MeSH)

D007223 - Infant, D001424 - Bacterial Infections

Keywords

infants, bacterial infection

Source Citation

WHO recommendations for management of serious bacterial infections in infants aged 0–59 days. Geneva: World Health Organization; 2024. Licence: CC BY-NC-SA 3.0 IGO.