Neonatal dosing
Neonatal dosing resources:
- Australasian Neonatal medicines formulary
- NeoMedQ (Queensland)
- Neofax (Micromedex, USA)
Aciclovir IV
| Gestational Age | Starting dose (use actual body weight) |
|---|---|
| Neonates younger than 30 weeks post menstrual age | 20 mg/kg/dose every 12 hours |
| Neonates 30 weeks post menstrual age or older | 20 mg/kg/dose every 8 hours |
Ampicillin IV (or Amoxycillin IV)
| Gestational Age | Post natal age | Starting dose (use actual body weight) |
|---|---|---|
| Neonates ≤ 29 weeks post menstrual age | Postnatal age 0 to 28 days | 50 mg/kg/dose every 12 hours |
| Neonates ≤ 29 weeks post menstrual age | Postnatal age more than 28 days | 50 mg/kg/dose every 8 hours |
| Neonates 30 to 36 weeks post menstrual age | Postnatal age 0 to 14 days | 50 mg/kg/dose every 12 hours |
| Neonates 30 to 36 weeks post menstrual age | Postnatal age 15 to 28 days | 50 mg/kg/dose every 8 hours |
| Neonates 37 to 44 weeks post menstrual age | Postnatal age 0 to 7 days | 50 mg/kg/dose every 12 hours |
| Neonates 37 to 44 weeks post menstrual age | Postnatal age 8 to 28 days | 50 mg/kg/dose every 8 hours |
| Neonates ≥ 45 weeks post menstrual age | All | 50 mg/kg/dose every 6 hours |
Benzylpenicillin IV
| Gestational Age | Post natal age | Starting dose (use actual body weight) |
|---|---|---|
| Neonates ≤ 29 weeks post menstrual age | Postnatal age 0 to 28 days | 60 mg/kg/dose every 12 hours |
| Neonates ≤ 29 weeks post menstrual age | Postnatal age more than 28 days | 60 mg/kg/dose every 8 hours |
| Neonates 30 to 36 weeks post menstrual age | Postnatal age 0 to 14 days | 60 mg/kg/dose every 12 hours |
| Neonates 30 to 36 weeks post menstrual age | Postnatal age 15 to 28 days | 60 mg/kg/dose every 8 hours |
| Neonates 37 to 44 weeks post menstrual age | Postnatal age 0 to 7 days | 60 mg/kg/dose every 12 hours |
| Neonates 37 to 44 weeks post menstrual age | Postnatal age 8 to 28 days | 60 mg/kg/dose every 8 hours |
| Neonates ≥ 45 weeks post menstrual age | ALL | 60 mg/kg/dose every 6 hours |
Cefotaxime IV
| Gestational Age | Post natal age | Starting dose (use actual body weight) |
|---|---|---|
| Neonates less than 35 weeks post menstrual age | Refer to Australasian Neonatal Medicines Formulary – available online via NeoMED consensus group | Refer to Australasian Neonatal Medicines Formulary – available online via NeoMED consensus group |
| Neonates more than 35 weeks post menstrual age | Postnatal age 0 to 7 days | 50 mg/kg/dose every 12 hours |
| Neonates more than 35 weeks post menstrual age | Postnatal age 8 to 28 days | 50 mg/kg/dose every 8 hours |
Clindamycin IV
| Gestational Age | Post natal age | Starting dose (use actual body weight) |
|---|---|---|
| Neonates ≤ 29 weeks post menstrual age | Postnatal age 0 to 28 days | 5 mg/kg/dose every 12 hours |
| Neonates ≤ 29 weeks post menstrual age | Postnatal age more than 28 days | 5 mg/kg/dose every 8 hours |
| Neonates 30 to 36 weeks post menstrual age | Postnatal age 0 to 14 days | 5 mg/kg/dose every 12 hours |
| Neonates 30 to 36 weeks post menstrual age | Postnatal age 15 to 28 days | 5 mg/kg/dose every 8 hours |
| Neonates 37 to 44 weeks post menstrual age | Postnatal age 0 to 7 days | 5 mg/kg/dose every 12 hours |
| Neonates 37 to 44 weeks post menstrual age | Postnatal age 8 to 28 days | 5 mg/kg/dose every 8 hours |
| Neonates ≥ 45 weeks post menstrual age | All | 5 mg/kg/dose every 6 hours |
Flucloxacillin IV
| Gestational Age | Post natal age | Starting dose (use actual body weight) |
|---|---|---|
| Term/ premature neonates | Postnatal age 0 to 7 days | 50 mg/kg/dose every 12 hours |
| Term/ premature neonates | Postnatal age 8 to 28 days | 50 mg/kg/dose every 8 hours |
Gentamicin IV**
Perform therapeutic drug monitoring (TDM)** (Dose based on ideal body weight)
| Gestational Age | Post natal age | Starting dose (use ideal body weight) |
|---|---|---|
| Neonates younger ≤ 29 weeks post menstrual age | Postnatal age 0 to 14 days | 5 mg/kg/dose every 48 hours** |
| Neonates younger ≤ 29 weeks post menstrual age | Postnatal age 15 to 28 days | 5 mg/kg/dose every 36 hours** |
| Neonates 30 to 34 weeks post menstrual age | Postnatal age 0 to 28 days | 5 mg/kg/dose every 36 hours** |
| Neonates 35 weeks post menstrual age or older | Postnatal age 0 to 28 days | 5 mg/kg/dose every 24 hours** |
Meropenem IV (severe/CNS infection)
| Gestational Age | Post natal age | Starting dose (use actual body weight) |
|---|---|---|
| Neonates – ALL gestational ages | Postnatal age 0 to 7 days | 40 mg/kg/dose every 12 hours |
| Neonates – ALL gestational ages | Postnatal age 8 to 28 days | 40 mg/kg/dose every 8 hours |
Metronidazole IV
| Gestational Age | Post natal age | Starting dose (use actual body weight) |
|---|---|---|
| Neonates ≤ 29 weeks post menstrual age | Postnatal age 0 to 28 days | 15 mg/kg IV as a single loading dose, then 7.5 mg/kg/dose every 24 hours |
| Neonates ≤ 29 weeks post menstrual age | Postnatal age more than 28 days | 15 mg/kg IV as a single loading dose, then 7.5 mg/kg/dose every 12 hours |
| Neonates 30 to 36 weeks post menstrual age | Postnatal age 0 to 14 days | 15 mg/kg IV as a single loading dose, then 7.5 mg/kg/dose every 12 hours |
| Neonates 30 to 36 weeks post menstrual age | Postnatal age 15 to 28 days | 15 mg/kg IV as a single loading dose, then 7.5 mg/kg/dose every 8 hours |
| Neonates 37 to 44 weeks post menstrual age | Postnatal age 0 to 7 days | 15 mg/kg IV as a single loading dose, then 7.5 mg/kg/dose every 12 hours |
| Neonates 37 to 44 weeks post menstrual age | Postnatal age 8 to 28 days | 15mg/kg IV as a single loading dose, then 7.5 mg/kg/dose every 8 hours |
| Neonates ≥ 45 weeks post menstrual age | All | 15 mg/kg IV as a single loading dose, then 7.5 mg/kg/dose every 8 hours |
Tobramycin IV**
Perform therapeutic drug monitoring (TDM)** (Dose based on ideal body weight)
| Gestational Age | Post natal age | Starting dose (use ideal body weight) |
|---|---|---|
| Neonates younger ≤ 29 weeks post menstrual age | Postnatal age 0 to 7 days | 5 mg/kg/dose every 48 hours** |
| Neonates younger ≤ 29 weeks post menstrual age | Postnatal age 8 to 28 days | 4 mg/kg/dose every 36 hours** |
| Neonates younger ≤ 29 weeks post menstrual age | Postnatal age more than 28 days | 4 mg/kg/dose every 24 hours** |
| Neonates 30 to 34 weeks post menstrual age | Postnatal age 0 to 7 days | 4.5 mg/kg/dose every 36 hours** |
| Neonates 30 to 34 weeks post menstrual age | Postnatal age 8 to 28 days | 4 mg/kg/dose every 24 hours** |
| Neonates 35 weeks post menstrual age or older | Postnatal age 0 to 28 days | 4 mg/kg/dose every 24 hours** |
Vancomycin IV**
Perform therapeutic drug monitoring (TDM)**
| Gestational Age | Post natal age | Starting dose (use actual body weight) |
|---|---|---|
| Neonates ≤ 29 weeks post menstrual age | Postnatal age 0 to 14 days | 15 mg/kg/dose IV 18 hourly** |
| Neonates ≤ 29 weeks post menstrual age | Postnatal age 15 to 28 days | 15 mg/kg/dose IV 12 hourly** |
| Neonates 30 to 36 weeks post menstrual age | Postnatal age 0 to 14 days | 15 mg/kg/dose IV 12 hourly** |
| Neonates 30 to 36 weeks post menstrual age | Postnatal age 15 to 28 days | 15 mg/kg/dose IV 8 hourly** |
| Neonates 37 to 44 weeks post menstrual age | Postnatal age 0 to 7 days | 15 mg/kg/dose IV 12 hourly** |
| Neonates 37 to 44 weeks post menstrual age | Postnatal age 8 to 28 days | 15 mg/kg/dose IV 8 hourly** |
| Neonates ≥ 45 weeks post menstrual age | All | 15 mg/kg/dose IV 6 hourly** |
Definitions
Postmenstrual age:
The time elapsed between the first day of the last menstrual period and birth (gestational age) plus the time elapsed after birth (postnatal age).
The time elapsed between the first day of the last menstrual period and birth (gestational age) plus the time elapsed after birth (postnatal age).
Renal function and drug elimination are most strongly correlated with Postmenstrual Age.
Perform therapeutic drug monitoring (TDM) for Gentamicin and Vancomycin.
