Template:Meningitis Antibiotics

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Guidelines[1]:

Age 18-50y

  1. Ceftriaxone 2gm IV q12hr + vancomycin 15mg/kg q8-12hr
  2. (vancomycin is for resistant pneumococcus)

Age >50y

  1. Ceftriaxone 2gm IV q12hr + vancomycin 15mg/kg q8-12hr + ampicillin 2gm IV q4h
  2. (Ampicillin is for Listeria)

CSF leak with closed head trauma

  1. Ceftriaxone 2gm IV q12hr + vancomycin 15mg/kg q8-12hr

Penetrating head injury (or recent surgery)

  1. (Ceftazidime 2gm IV q8hr or cefepime or meropenem) + vanco 25 milligrams/kg load

Meningitis due to Sinusitis

  1. Ceftriaxone + Metronidazole

Meningitis with severe PCN allergy

  1. chloramphenicol 1g IV q6h + vancomycin 15mg/kg q8-12hr
  1. ↑ van de Beek D. et al. Advances in treatment of bacterial meningitis. Lancet. Nov 10 2012;380(9854):1693-702
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