Meningitis

Question 1

Mention dose & administration precautions of dexamethasome

Answer 1

15 mg/kg/6h IV, 10-20 min before or concomitant with Abx fir 1st 2-4 days

Question 2

…….can be administered intra-thecally, while…..can’t

Answer 2

Gentamycin, vancomycin
Penicillins, cephalosporins

Question 3

Mention 1st line treatment in:
1. Less than 1 mon
2. 1 mon-50 yrs
3. Immunosuppressed/or more than 50
4. Penetrating wound/iatrogenic

Answer 3

1. Ampicillin + cefotaxime
2. Vancomycin + ceftriaxone
3. Vancomycin + ceftriaxone + ampicillin
4. Vancomycin + cefepime

Question 4

Describe drug therapy of S.pneumoniae meningtits

Answer 4

Penicillin, MIC less than 0.1ug/ml, penicillin G
From 0.1-1 ug/ml, ceftriaxome
More than 1 or that if ceftriaxome is more than 2, Ceftriaxone + vancomycin

Question 5

Describe drug therapy of N.meningitidis & H.influenza meningtits

Answer 5

N, P MIC less than 0.1 ug/ml, penicillin G (ampicillin)
more than 0.1, Ceftriaxone
H, b-lactamase -ve: Ampicillin, b-lactamase +ve: Ceftriaxone

Question 6

Describe drug therapy of following oragnisms meningtits
1. S.agalactiae
2. Listeria
3. Enterobacteria
4. Pseudomonas
5. S.aureus

Answer 6

1. Penicillin G or ampicillin
2. Ampicillin + gentamycin
3. Ceftriaxone + gentamicin
4. Cefepime
5. MRSA, vancomycin, non, nafcilin

Question 7

GR: Chloramphenicol use is limited

Answer 7

Risk of fatal aplastic anemia & Grey baby syndrome

Question 8

Chemoprophylaxis of bacterial meningitis in:
1. H.influenza
2. N.meningitidis
3. Strept.Agalac

Answer 8

1. Postexposure, no need if fully vaccinated, rifampin (4 days) 20 mg/kg/day up to 600mg/day
2. Postexposure, no need if conatct from >14 days, rifampin (2 days) as prev
3. Intrapartum in women, prnicillin G

Question 9

HSV meningitis should recieve….., while that of candida meningitis is……

Answer 9

Acyclovir
Liposomal amphotericin B + 5-flucytosine

Question 10

Mention advantages of liposomal than conventional ampho-B

Answer 10

Higher CNA conc & less nephrotoxic

Question 11

Duration of ttt of TB meningitis is…..

Answer 11

9-12 months