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 ≥60 years of age, 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 (max 2g) IV 6 hourly

In all patients ≥60 years of age, or immunocompromised, and in all other cases where Listeria is suspected, add co-trimoxazole IV 30mg/kg 6 hourly. 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: