Bacterial Meningitis

Question 1

Antibiotics given prophylactically to those in close contacts with meningitis?

Answer 1

Rifampin

Question 2

H.influenza B prophylactic therapy?

Answer 2

H. Influenza B: Rifampin once daily x 4 days (no dose for children < 1 month)

Question 3

N.Meningitis prophylactic therapy?

Answer 3

N. meningitis: Rifampin BID x 2 days in all contacts (lower dose for < 1 month) * Cetriaxone IM x 1 dose can be used for all contacts (1st choice in pregnancy).
* Ciprofloxacin PO x 1 dose can be used for close contacts ≥ 1 month of age

Question 4

Therapy for kids under 1 month?

Answer 4

Ampicillin + cefotaxime
(add gentamicin if synergy for group B streptococcal infections).

Question 5

kids for >1month?

Answer 5

Ceftriaxone or cefotaxime
+/- vancomycin

Question 6

Adults without medical conditions?

Answer 6

Ceftriaxone or cefotaxime
+/- vancomycin

Question 7

Adults with any of the following: age >60 y, chemotherapy, HIV, pregnancy, humoral immune deficiency states, e.g., agammaglobulinemia, exposure to biologic therapy (especially eculizumab), malignancy, transplantation, alcohol use disorder or any parenchymal involvement in the brainstem?

Answer 7

Ceftriaxone or cefotaxime
+ ampicillin
+/- vancomycin