Paediatric drug doses: emergency

Question 1

IM benzylpenicillin for suspected meningococcal septicaemia in the community

Answer 1

< 1 year 300 mg
1 - 10 years 600 mg
> 10 years 1200 mg

Question 2

Meningitis in children: investigation and management

Answer 2

Contraindication to lumbar puncture (any signs of raised ICP)
focal neurological signs
papilloedema
significant bulging of the fontanelle
disseminated intravascular coagulation
signs of cerebral herniation

1. Antibiotics
   < 3 months: IV amoxicillin (or ampicillin) + IV cefotaxime
   > 3 months: IV cefotaxime (or ceftriaxone)
2. Steroids
   NICE advise against giving corticosteroids in children younger than 3 months
   dexamethsone should be considered if the lumbar puncture reveals any of the following:
   frankly purulent CSF
   CSF white blood cell count greater than 1000/microlitre
   raised CSF white blood cell count with protein concentration greater than 1 g/litre
   bacteria on Gram stain