CNS infections therapeutics Flashcards
When is empiric therapy started for meningitis?
AFTER the lumbar puncture is performed
How is the duration of treatment for meningitis calculated?
All effective days of therapy (empiric + directed)
What is the meningitis empiric therapy for neonates (<1 month)?
- Ampicillin + ceftriaxone/cefepime, or
- Ampicillin + genta
What is the meningitis empiric therapy for infants (1-23 months)?
Vanco + ceftriaxone
What is the meningitis empiric therapy for children and adults (2-50 yo)?
Vanco + ceftriaxone
What is the meningitis empiric therapy for immunocompromised older adults (>50 yo)?
Vanco + ceftriaxone + ampicillin
What is the meningitis directed therapy for S. pneumoniae?
- Pen suscep: pen g or ampicillin
- Pen resis: vanco + ceftriaxone
for 10-14 days
What is the meningitis directed therapy for group B strep?
Ampicillin +/- genta for 14-21 days
What is the meningitis directed therapy for S. aureus?
- MSSA: nafcillin
- MRSA: vanco
for 14-21 days
What is the meningitis directed therapy for L. monocytogenes?
Amp +/- genta for 21 days
What is the meningitis directed therapy for N. meningitidis?
Penicillin or ceftriaxone for 7 days
What is the meningitis directed therapy for H. influenzae?
- BL-: amp
- BL+: ceftriaxone
for 7 days
What is the meningitis directed therapy for gram negative?
Ceftriaxone or cefepime for 21 days
What is the treatment for general viral encephalitis?
Supportive care, fluid, analgesics, antipyretics
What is the treatment for HSV encephalitis in adults?
Acyclovir 10 mg/kg IV q8hrs for 14-21 days
What is the treatment for HSV encephalitis in neonates?
Acyclovir 20 mg/kg IV q8hrs for 21 days
What is the treatment for VZV encephalitis?
Acyclovir
Alt: gancyclovir
What is the treatment for CMV encephalitis?
Ganciclovir
