Treatment of Ebola Virus Disease in the Neonate with Bacterial Co-infection

Neonates with Ebola virus disease are at particular risk of concurrent bacterial infection. Recognising and treating bacterial co-infection alongside the primary viral illness is a critical component of neonatal care in this setting.

Clinical scenario

This protocol applies to neonates — patients in the earliest weeks of life — who present with Ebola virus disease and evidence of bacterial co-infection. Age and birth weight are key determinants of how the co-infection is managed.

Treatment approach

Management centres on a combination antibiotic regimen, with the choice of agents guided by the likely causative organism. Dosing is specifically adjusted for the neonate's age and weight throughout the treatment course.

Full regimen, agent selection criteria, dosing schedule, and duration are available in the complete protocol.

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References

Ampicillin plus gentamycin or cloxacillin PLUS gentamycin (if Staphylococcus aureus suspected) or cefotaxime PLUS gentamycin.
Duration of antibiotics: generally 7–10 days, but may be prolonged if meningitis present.
First week of life: 50 mg/kg IV 12 hourly
First week of life: low birth weight: 3 mg/kg once a day
Note: ceftriaxone is not recommended for use in neonates as there is increased risk of kernicterus, especially in those with elevated bilirubin.

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