STREP PNEUMONIAE & H. FLU TYPE B.

Question 1

Strep Pneumo Vaccination Series

Answer 1

Pneumococcal Conjugate Vaccine (PCV13 or Prevnar®13):

2, 4, and 12 months (3 dose series)

Reduces invasive pneumococcal disease by 97% among those 13 serotypes

Question 2

Infections caused by Strep Pneumo & H. Flu

Answer 2

Meningitis
Sepsis
Otitis Media
Pneumonia
Endocarditis
Pericarditis
Septic Arthritis

Epiglotittis - H. Flu

Question 3

Antibiotics with Strep Pneumo coverage

Answer 3

Invasive (Meningitis, Sepsis):

Ceftriaxone 100 mg/kg IV q12-24h
OR
Cefotaxime 150 mg/kg IV q8h

Vancomycin 45-60 mg/kg/d IV/intraosseous q6-8h

Non-invasive (AOM, CAP):
Amoxicillin, 80-100 mg/kg/d PO divided q12h (max: 4 g/d)

Question 4

Management of H. Flu

Answer 4

Amoxicillin-clavulanic acid

Vancomycin 40 mg/kg/d IV divided q6h (age 1 mo to 6 yr) or q8h (age 7 yr +) with cefotaxime 50 mg/kg/dose IV q12h (<1 wk of life) or q8h (1-4 wk); 50-180 mg/kg/d (1 mo to 12 yr) divided q6h, 1-2 g (>50 kg) q6-12h or
Vancomycin with ceftriaxone IV/IM, 50-100 mg/kg/d (pediatric) q12-24h or 1-2 g/d (adult) q12-24h

For meningitis, consider dexamethasone 0.4 mg/kg every 12 hours for 4 doses with first dose prior to antibiotics if possible.
Post-exposure prophylaxis should be considered as well with rifamipin 20 mg/kg per dose once daily (maximal daily dose 600 mg) for 4 days.