This protocol addresses tularemia in the neonatal period — specifically full-term infants aged 28 days or younger, and premature infants who have reached 37–44 weeks postmenstrual age. This age-defined population requires careful antimicrobial selection given the physiological and pharmacological constraints of the neonate.
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. The available antimicrobial options and their hierarchy differ from those used in older infants and children.
When first-line and second-line antimicrobial options have been exhausted, third-tier agents may be considered for neonates with tularemia.
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.
Chloramphenicol and streptomycin are third-tier options for treatment of tularemia in neonates and can be considered if other recommended antimicrobial options have been exhausted.
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