Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-In-Chief: Cafer Zorkun, M.D., Ph.D. [2]
Medical Therapy
Empiric Treatment
- Do not wait for the results of the CT scan and the lumbar puncture; empiric treatment should be started as soon as possible.
- Blood cultures should be drawn before starting the antibiotic therapy, and then the antibiotic treatment should be changed once the blood culture results are out.
- Empiric antibiotic treatment should be started within 30 minutes after the patient presentation.
- In case of high suspicion of pneumococcal meningitis in adult patients, 0.15 mg/kg IV Q6H dexomethasone should be administered for 2 to 4 days.
- The first dose of dexomethasone is given along with or 20 minutes prior to starting the antibiotics treatment.
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Age 1—23 Months
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Preferred Regimen
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▸ Vancomycin 15 mg/kg IV q6 h
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AND
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▸ Cefotaxime 225–300 mg/kg per day IV q6–8 h OR ▸ Ceftriaxone 80–100 mg/kg per day IV q12–24 h¤
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Age 2–50 years
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Preferred Regimen
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▸ Children's dosage is as shown left,shown below is the adult
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▸ Vancomycin 30–60 mg/kg per day IV8–12 h
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AND
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▸ Cefotaxime 8–12 g per day IVq4–6h OR ▸ Ceftriaxone 2 g IV q12 h¤
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¤Add amoxicillin or ampicillin if meningitis caused by L monocytogenes is also suspected. Ampicillin if meningitis caused by L monocytogenes is also suspected
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