Treatment of Bacterial Infections and Syphilis (Birth up to 2 months)

Treat for Possible Serious Bacterial Infection with Intramuscular Ceftriaxone

Treat Skin Pustules or Red Umbilicus with Cephalexin or Flucloxacillin

Give Intramuscular Penicillin for Possible Congenital Syphilis

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Treat for Possible Serious Bacterial Infection with Intramuscular Ceftriaxone

• Give first dose of ceftriaxone IM
• The dose of ceftriaxone is 50 mg per kilogram
• Dilute a 250 mg vial with 1 ml of sterile water
• Also give one dose of ceftriaxone if the infant has local bacterial infection with a purulent discharge of eyes

Ceftriaxone Injection: Give a single dose in the clinic
Weight	Ceftriaxone (250 mg in 1ml)
>2 - 2.5 kg	0.75 ml
>2.5-3.5 kg	0.9 ml
>3.5-5.5 kg	1.25 ml

Treat Skin Pustules or Red Umbilicus with Cephalexin or Flucloxacillin

• Give cephalexin OR  flucloxicillin for 7 days
• If child has penicillin allergy, refer

Cephalexin or Flucloxicillin: Give four times a day for seven days
Weight	Cephalexin syrup 125 mg in 5 ml	Flucloxicillin syrup 125 mg in 5 ml
Up to 5 kg	2.5 ml	2.5 ml
≥ 5kg	5 ml	5 ml

Give Intramuscular Penicillin for Possible Congenital Syphilis

Give once only

• Give Benzathine Benzylpenicillin IM (injection) 50000 units / kg into the lateral thigh
• Dilute 1.2 million units with 4 ml of sterile water to give in the clinic
• Refer all babies if the mother is RPR positive and the baby presents with Low birth Weight OR Blisters on hands and feet OR Pallor OR petechiae OR hepatosplenomegaly OR if you are unsure

Weight	Benzathine Benzylpenicillin injection 300 000 units in 1 ml
2.5 - < 3.5 kg	0.5 ml
3.5 - < 5 kg	0.75ml
> 5 kg	1 ml

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Integrated Management of Childhood Illness 2022; Young Infant (Birth up to 2 months); Treat the Young Infant: Ceftriaxone, Penicillin, Cephalexin

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Last checked for updates: June 2023