Bacterial meningitis Flashcards
Empiric treatment for < 1 month old (incl duration)
IV Ceftriaxone + Ampicillin x 14d
Empiric tx for 1-23 months old
IV Ceftriaxone + Vancomycin x 14d
Empiric tx for adult 2-50 y/o
IV Ceftriaxone + Vancomycin x 14d
Empiric tx for adult > 50y/o (incl duration)
IV ceftriaxone + vancomycin + ampicillin x 14d
Culture-directed for S. pneumoniae (Penicillin susceptible)
Penicillin G or Ampicillin
x10 - 14d
Culture-directed for S. pneumoniae (Penicillin resistant, cephalosporin susceptible)
Ceftriaxone x10 - 14d
Culture-directed for S. pneumoniae (Penicillin, cephalosporin resistant)
Vancomycin plus rifampicin
x10 - 14d
Culture-directed N. meningitidis (Penicillin susceptible)
Penicillin or Ampicillin
Culture-directed N. meningitidis (Penicillin resistant or mild allergy)
Ceftriaxone x 5-7d
Culture-directed L. monocytogenes (no penicillin allergy)
Penicillin G or Ampicillin
x at least 21 days
Culture-directed L. monocytogenes (Penicillin allergy)
Co-trimoxazole, meropenem
x at least 21 days
Culture-directed S. agalactiae (no penicillin allergy)
IV Penicillin or Ampicillin
x 14-21d
Culture-directed S. agalactiae (Penicillin, mild allergy)
IV Ceftriaxone
x 14-21d
Regimen & counselling for dexamethasone (adult)
Dexamethasone 10 mg every 6 hours for up to 4 days. Administer 10–20 minutes before or at same time as first dose of antibiotics.
If culture-negative, treat with __(what)___for ( ) days, may be extended depending on condition of patient.
empiric antibiotic for at least 14 days
Who could be given adjunctive corticosteroids?
- Meningitis caused by strep pneumo/ h. influenzae
- More than 6 weeks old
Chemoprophylaxis regimen for close contact (Neisseria)
Rifampicin:
- Adults: 600 mg every 12 hours, four doses
- Children: 10 mg/kg every 12 hours, four doses
- Infants (younger than 1 month): 5 mg/kg every 12 hours, four doses
OR
- PO Ciprofloxacin 500 mg, one dose (adults only)
OR
- IM Ceftriaxone 125–250 mg, one dose
