Bacterial Meningitis

Important: Therapy

On Admission (adults):-

Cefotaxime IV 2g 6 hourly increased if necessary to 12g daily in 3-4 divided doses.

change to

Benzylpenicillin IV 2.4g 4 hourly if culture shows meningococcal disease or sensitivities indicate

In all patients over 50 years or immunocompromised, and in all other cases where Listeria is suspected, add amoxicillin IV 2g every 4 hours.

Consider dexamethasone 10mg IV 6 hourly for 4 days started BEFORE or with first dose of antibiotic, especially where S.pneumoniae is most likely pathogen

Notes:

Important: Therapy

If history of anaphylaxis or bronchospasm with Penicillin, discuss with Consultant Microbiologist

Chloramphenicol 25mg/kg IV 6 hourly

In all patients over 50 years or immunocompromised, and in all other cases where Listeria is suspected, add co-trimoxazole IV 120mg/kg/daily in 4 divided doses. Seek advice if patient is obese.

Consider dexamethasone 10mg IV 6 hourly for 4 days started BEFORE or with first dose of antibiotic, especially where S.pneumoniae is most likely pathogen.

Notes: