Unique Plan Description: NICU Antibiotics (WH)
Plan Selection Display: NICU Antibiotics (WH)
PlanType: Medical                                 
Version: 2          
Begin Effective Date: 2022-03-22 17:26:17
End Effective Date: 2100-12-31 00:00:00
Last Updated Date: 2023-09-01 12:02:36
Available at all facilities: No

NICU Antibiotics (WH)
Medications
	acyclovir IVPB (NICU)
		20 mg/kg, Solution-Injection, IVPB, Q8H, Indication: Late onset neonatal sepsis
			Comment: PMA (Weeks)         Interval (hours)< 30                         Q12H30-36                       Q8H                                                                                                                                       > 36                        Q6H
		20 mg/kg, Solution-Injection, IVPB, Q12H, Indication: Late onset neonatal sepsis
			Comment: PMA (Weeks)         Interval (hours)< 30                         Q12H30-36                       Q8H                                                                                                                                       > 36                        Q6H
		20 mg/kg, Solution-Injection, IVPB, Q6H, Indication: Late onset neonatal sepsis
			Comment: PMA (Weeks)         Interval (hours)< 30                         Q12H30-36                       Q8H                                                                                                                                       > 36                        Q6H
	ampicillin IVPB (NICU)
		100 mg/kg, Solution-Injection, IVPB, TID, Early onset neonatal sepsis, T;N, 36 hr
			Comment: Ampicillin: 100mg/kg/dose IV TID        PNA < 7 days old Ampicillin: 75mg/kg/dose IV QID          PNA >7 days old
	Unasyn IVPB (NICU)
		150 mg/kg, Solution-Injection, IVPB, Q12H, Late onset neonatal sepsis
			Comment: PMA (Weeks)         Postnatal (days)         Interval (hours)<= 29                      0 to 28                       Q12H<= 29                       >28                           Q8H30 to 36                  0 to 14                       Q12H30 to 36                  >14                            Q8H37 to 44                  0 to 7                         Q12H37 to 44                  >7                              Q8H>= 45                      All                               Q6H
	AmBisome (NICU)
		5 mg/kg, Solution-Injection, IVPB, Q24H, Other- type in, Late onset neonatal sepsis
	Ancef IVPB (NICU)
		25 mg/kg, Solution-Injection, IVPB, Q12H, Late onset neonatal sepsis
			Comment: PMA (Weeks)         Postnatal (days)         Interval (hours)<= 29                      0 to 28                       Q12H<= 29                       >28                           Q8H30 to 36                  0 to 14                       Q12H30 to 36                  >14                            Q8H37 to 44                  0 to 7                         Q12H37 to 44                  >7                              Q8H>= 45                      All                               Q6H
		30 mg/kg, Solution-Injection, IVPB, PREOP, Surgical prophylaxis
			Comment: Send to OR with patient, to be given 30 minutes prior to procedure
	Maxipime (NICU)
		50 mg/kg, Solution-Injection, IVPB, Q12H, Late onset neonatal sepsis
		30 mg/kg, Solution-Injection, IVPB, Q12H, Late onset neonatal sepsis
	clindamycin IVPB (NICU)
		5 mg/kg, Solution-Injection, IVPB, Q12H, Bacteremia
			Comment: PMA (Weeks)         Postnatal (days)         Interval (hours)<= 29                      0 to 28                       Q12H<= 29                       >28                           Q8H30 to 36                  0 to 14                       Q12H30 to 36                  >14                            Q8H37 to 44                  0 to 7                         Q12H37 to 44                  >7                              Q8H>=45                       All                               Q6H
		5 mg/kg, Injection, IVPB, Q8H, Bacteremia
			Comment: PMA (Weeks)         Postnatal (days)         Interval (hours)<= 29                      0 to 28                       Q12H<= 29                       >28                           Q8H30 to 36                  0 to 14                       Q12H30 to 36                  >14                            Q8H37 to 44                  0 to 7                         Q12H37 to 44                  >7                              Q8H>=45                       All                               Q6H
		5 mg/kg, Injection, IVPB, Q6H, Bacteremia
			Comment: PMA (Weeks)         Postnatal (days)         Interval (hours)<= 29                      0 to 28                       Q12H<= 29                       >28                           Q8H30 to 36                  0 to 14                       Q12H30 to 36                  >14                            Q8H37 to 44                  0 to 7                         Q12H37 to 44                  >7                              Q8H>=45                       All                               Q6H
	Diflucan IVPB (NICU)
		25 mg/kg, Injection-Premix, IVPB, Once, Other- type in, Late onset neonatal sepsis, Infuse Over 60 min(s)
		12 mg/kg, Injection-Premix, IVPB, Q24H, Other- type in, Late onset neonatal sepsis
			Comment: PMA (Weeks)         Postnatal (days)         Interval (hours)<= 29                      0 to 14                       Q48H<= 29                       >28                           Q24H30 and older            0 to 7                        Q48H                                >7                             Q24H
	gentamicin IVPB (NICU)
		5 mg/kg, Injection, IVPB, Once, Early onset neonatal sepsis, T;N
			Comment: < 30 weeks: 5 mg/kg q48h>=30 weeks: 5 mg/kg q36h
	tobramycin IVPB (NICU)
		5 mg/kg, Solution-Injection, IVPB, Q36H, Late onset neonatal sepsis
			Comment: use q48h dosing if PMA less than 30 weeks
	meropenem (NICU)
		20 mg/kg, Solution-Injection, IVPB, Q12H, Indication: Late onset neonatal sepsis
	Flagyl IVPB (NICU)
		15 mg/kg, Injection-Premix, IVPB, Once, Other- type in, Late onset neonatal sepsis
			Comment: PMA (Weeks)         Postnatal (days)         Interval (hours)<= 29                      0 to 28                       Q48H<= 29                       >28                           Q24H30 to 36                  0 to 14                       Q24H30 to 36                  >14                            Q12H37 to 44                  0 to 7                         Q24H37 to 44                  >7                              Q12H>= 45                      All                               Q8H
		7.5 mg/kg, Injection-Premix, IVPB, Q12H, Other- type in, Late onset neonatal sepsis
			Comment: PMA (Weeks)         Postnatal (days)         Interval (hours)<= 29                      0 to 28                       Q48H<= 29                       >28                           Q24H30 to 36                  0 to 14                       Q24H30 to 36                  >14                            Q12H37 to 44                  0 to 7                         Q24H37 to 44                  >7                              Q12H>= 45                      All                               Q8H
	Penicillin G potassium NICU 60,000units/mL/D5W
		125,000 units/kg, Injection-Premix, IVPB, Q6H, Late onset neonatal sepsis
			Comment: Program IV pump as ____mL/kg (round to nearest tenth).
	Unipen (NICU)
		25 mg/kg, Solution-Injection, IVPB, Q8H, Late onset neonatal sepsis
			Comment: PMA (Weeks)         Postnatal (days)         Interval (hours)<= 29                      0 to 28                       Q12H<= 29                       >28                           Q8H30 to 36                  0 to 14                       Q12H30 to 36                  >14                            Q8H37 to 44                  0 to 7                         Q12H37 to 44                  >7                              Q8H>= 45                      All                               Q6H
		25 mg/kg, Solution-Injection, IVPB, Q12H, Late onset neonatal sepsis
		25 mg/kg, Solution-Injection, IVPB, Q6H, Late onset neonatal sepsis
	Zosyn (NICU)
		110 mg/kg, Injection-Premix, IVPB, Q8H, Late onset neonatal sepsis
			Comment: Body weight <=2 kg:PNA <=7 days: 110 mg/kg/dose every 8 hoursPNA 8 to 28 days: 90 mg/kg/dose every 6 hoursBody weight >2 kg:PNA <=60 days: 90 mg/kg/dose every 6 hours
	vancomycin IVPB (NICU)
		15 mg/kg, Injection-Premix, IVPB, Q8H, Late onset neonatal sepsis
			Comment: PMA (Weeks)         Postnatal (days)         Interval (hours)<= 29                      0 to 14                       Q18H<= 29                       >14                           Q12H30 to 36                  0 to 14                       Q12H30 to 36                  >14                            Q8H37 to 44                  0 to 7                         Q12H37 to 44                  >7                              Q8H>= 45                      All                               Q6H
		15 mg/kg, Injection-Premix, IVPB, Q12H, Late onset neonatal sepsis
			Comment: PMA (Weeks)         Postnatal (days)         Interval (hours)<= 29                      0 to 14                       Q18H<= 29                       >14                           Q12H30 to 36                  0 to 14                       Q12H30 to 36                  >14                            Q8H37 to 44                  0 to 7                         Q12H37 to 44                  >7                              Q8H>= 45                      All                               Q6H
		15 mg/kg, Injection-Premix, IVPB, Q6H, Late onset neonatal sepsis
			Comment: PMA (Weeks)         Postnatal (days)         Interval (hours)<= 29                      0 to 14                       Q18H<= 29                       >14                           Q12H30 to 36                  0 to 14                       Q12H30 to 36                  >14                            Q8H37 to 44                  0 to 7                         Q12H37 to 44                  >7                              Q8H>= 45                      All                               Q6H
	nystatin  100,000 units/mL oral suspension
		1 mL, Suspension, BY MOUTH, Q6H, Other- type in, Late onset neonatal sepsis, 10 Day(s)
	nystatin topical 100,000 units/gm ointment
		1 appl, Ointment, TOPICAL, Q2H, PRN, diaper rash, 10 Day(s)
			Comment: Apply with diaper change.
	Tobrex 0.3% ophthalmic ointment
		1 appl, Ointment, EYE, BOTH, Q8H
	Tobrex 0.3% ophthalmic solution
		1 gtt, Soln, EYE, BOTH, Q4H
	mupirocin 2% topical ointment
		1 appl, Ointment, TOPICAL, Q6H
Consults/Follow-up
	Pharmacy Consult
		T;N, Pharmacy to order peak and trough levels for aminogylcosides & vancomycin around 3rd dose if applicable.

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IND - This component is an indicator
INT - This component is an intervention
IVS - This component is an IV Set
NOTE - This component is a note
Rx - This component is a prescription
SUB - This component is a sub phase