Neisseria meningitidis
(Redirected from N. meningitidis)
See meningitis for a general approach to the disease entity
Background
- Gram negative diplococci that causes bacterial meningitis
Clinical Features
Severe meningococcal meningitis with classic petechial rash progressing to gangrene.
- A cause of meningitis
- Rash
- Approximately 2/3 of patients with meningococcemia develop rash.[1]
- Can include erythematous, morbilliform, or urticarial macules and papules[2]
- Most common hallmark is purpuric lesions with jagged edges. [3]
Post exposure prophylaxis
- Ceftriaxone 250mg IM once (if less than 15yr then 125mg IM)
- Ciprofloxacin 500mg PO once
- Rifampin 600 mg PO BID x 2 days
- if < 1 month old then 5mg/kg PO BID x 2 days
- if ≥ 1 month old then 10mg/kg (max at 600mg) PO BID x 2 days
Antibiotic Sensitivities[4]
| Category | Antibiotic | Sensitivity |
| Penicillins | Penicillin G | S |
| Penicillin V | R | |
| Anti-Staphylocccal Penicillins | Methicillin | R |
| Nafcillin/Oxacillin | R | |
| Cloxacillin/Diclox. | R | |
| Amino-Penicillins | AMP/Amox | S |
| Amox-Clav | S | |
| AMP-Sulb | S | |
| Anti-Pseudomonal Penicillins | Ticarcillin | S |
| Ticar-Clav | S | |
| Pip-Tazo | S | |
| Piperacillin | S | |
| Carbapenems | Doripenem | S |
| Ertapenem | S | |
| Imipenem | S | |
| Meropenem | S | |
| Aztreonam | S | |
| Fluroquinolones | Ciprofloxacin | S |
| Ofloxacin | S | |
| Pefloxacin | S | |
| Levofloxacin | S | |
| Moxifloxacin | S | |
| Gemifloxacin | X1 | |
| Gatifloxacin | S | |
| 1st G Cephalo | Cefazolin | R |
| 2nd G. Cephalo | Cefotetan | I |
| Cefoxitin | I | |
| Cefuroxime | S | |
| 3rd/4th G. Cephalo | Cefotaxime | S |
| Cefizoxime | I | |
| CefTRIAXone | S | |
| Ceftaroline | S | |
| CefTAZidime | I | |
| Cefepime | S | |
| Oral 1st G. Cephalo | Cefadroxil | R |
| Cephalexin | R | |
| Oral 2nd G. Cephalo | Cefaclor/Loracarbef | I |
| Cefproxil | I | |
| Cefuroxime axetil | I | |
| Oral 3rd G. Cephalo | Cefixime | I |
| Ceftibuten | I | |
| Cefpodox/Cefdinir/Cefditoren | X1 | |
| Aminoglycosides | Gentamicin | R |
| Tobramycin | R | |
| Amikacin | R | |
| Chloramphenicol | S | |
| Clindamycin | R | |
| Macrolides | Erythromycin | X2 |
| Azithromycin | X2 | |
| Clarithromycin | X1 | |
| Ketolide | Telithromycin | X2 |
| Tetracyclines | Doxycycline | S |
| Minocycline | S | |
| Glycylcycline | Tigecycline | X1 |
| Daptomycin | R | |
| Glyco/Lipoclycopeptides | Vancomycin | R |
| Teicoplanin | R | |
| Telavancin | R | |
| Fusidic Acid | S | |
| Trimethoprim | I | |
| TMP-SMX | X2 | |
| Urinary Agents | Nitrofurantoin | X1 |
| Fosfomycin | X1 | |
| Other | Rifampin | S |
| Metronidazole | R | |
| Quinupristin dalfoppristin | R | |
| Linezolid | R | |
| Colistimethate | R |
Key
- S susceptible/sensitive (usually)
- I intermediate (variably susceptible/resistant)
- R resistant (or not effective clinically)
- S+ synergistic with cell wall antibiotics
- U sensitive for UTI only (non systemic infection)
- X1 no data
- X2 active in vitro, but not used clinically
- X3 active in vitro, but not clinically effective for Group A strep pharyngitis or infections due to E. faecalis
- X4 active in vitro, but not clinically effective for strep pneumonia
Table Overview
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See Also
References
- ↑ Sara Bode; Contagious Exanthematous Diseases. Quick References 2022; 10.1542/aap.ppcqr.396150
- ↑ Sara Bode; Contagious Exanthematous Diseases. Quick References 2022; 10.1542/aap.ppcqr.396150
- ↑ Sara Bode; Contagious Exanthematous Diseases. Quick References 2022; 10.1542/aap.ppcqr.396150
- ↑ Sanford Guide to Antimicrobial Therapy 2014