Treatment of Tularemia in Full-Term Neonates (≤28 Days) and Premature Infants at 37–44 Weeks Postmenstrual Age

Tularemia in the neonatal period presents a distinct clinical challenge. This protocol addresses the specific sub-population of full-term infants aged 28 days or younger, as well as premature infants who have reached 37–44 weeks postmenstrual age.

Patient Population

Neonates are defined here as full-term infants aged ≤28 days, or infants born prematurely who have reached 37–44 weeks postmenstrual age. This age-based distinction directly shapes which treatment options apply.

Treatment Approach — Partial Overview

For this neonatal age group, alternative antibiotic options are available, including agents from different classes. The choice and route of administration may depend on whether intravenous access can be established.

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References

For these recommendations, neonates are defined as full-term infants aged ≤28 days or infants born premature who have reached 37–44 weeks postmenstrual age.

Levofloxacin, amikacin, tobramycin, and doxycycline can be used as alternative options.

If IV access cannot be obtained, doxycycline can be administered orally to neonates for treatment of tularemia if a nasogastric tube has been placed.

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