Meningococcemia medical therapy
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Meningococcemia Microchapters |
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-In-Chief: Cafer Zorkun, M.D., Ph.D. [2]
Overview
Treatment
Acute Pharmacotherapies
- Cephalosporin CSF penetration: cefuroxime 11-14 %; ceftriaxone 1.5-7%, cefotaxime 4-54%, and ceftazidime 14%.
- Ceftriaxone CSF half life approximately 5 hours.
- Potential antibiotics include cephalosporins, penicillin, and chloramphenicol.
- Therapy may be as brief as 10 to 14 days in fully sensitive organisms.
- Steroid use particularly in purpura fulminans and adrenal hemorrhage (Waterhouse-Friderichsen syndrome) is controversial.
Prophylaxis
- Rifampin 600 mg PO q12h x 4 doses total or alternatively ciprofloxacin 500 mg PO x 1 in patients over 18 who cannot tolerate rifampin