Template:Meningitis Antibiotics: Difference between revisions
No edit summary
Line 1: Line 1:
====Guidelines:<ref>van de Beek D. et al. Advances in treatment of bacterial meningitis. Lancet. Nov 10 2012;380(9854):1693-702</ref>====
''treatment guidelines based on van de Beek et al''<ref>van de Beek D. et al. Advances in treatment of bacterial meningitis. Lancet. Nov 10 2012;380(9854):1693-702</ref>
;Age 18-50y
===Neonates (up to 1 month of age)===
*[[Ceftriaxone]] 2gm IV q12hr + [[vancomycin]] 15mg/kg q8-12hr
''MRSA is uncommon in the neonate
**([[vancomycin]] is for resistant [[pneumococcus]])
*[[Ampicillin]] 50mg/kg IV q6hrs PLUS
;Age >50y
**[[Cefotaxime]] 50mg/kg IV q6hrs OR
**[[Gentamicin]] 2.5mg/kg IV q8hrs
*If suspecting [[S. pneumoniae]] or [[MRSA]], add [[vancomycin]] 1
===> 1 month to Adult===
*[[Vancomycin]] 15-20 mg/kg IV BID daily PLUS
**[[Ceftriaxone]] 2gm (50mg/kg) IV BID daily
'''[[Vancomycin]] is for resistant [Pneumococcus]])'''
===Post Procedural (or penetrating trauma)===
*[[Vancomycin]] 15-20mg/kg IV BID daily PLUS either
**[[Cefepime]] 2g (50mg/kg) IV q8 hours daily OR
**[[Ceftazidime]] 2g (50mg/kg) IV q8 hours daily OR
**[[Meropenem]] 2gm (40mg/kg) IV q8 hours daily
===[[Cryptococcosis]] Meningitis===
'''Options'''
*Amphotericine B 1mg/kg IV once daily AND Fluctosine 25mg/kg PO q6hrs daily
*Amphotericine B 5mg/kg IV once daily AND Flucytosine 25mg/kg PO q6hrs daily
 
===[[Neisseria meningitidis]] Prophylaxis===
*[[Ceftriaxone 250mg IM once (if less than 15yo 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 
 
===Meningitis with severe PCN allergy===
*[[Chloramphenicol]] 1g IV q6h + [[Vancomycin]] 15mg/kg q8-12hr
 
===Age >50y===
*[[Ceftriaxone]] 2gm IV q12hr + [[vancomycin]] 15mg/kg q8-12hr + [[ampicillin]] 2gm IV q4h
*[[Ceftriaxone]] 2gm IV q12hr + [[vancomycin]] 15mg/kg q8-12hr + [[ampicillin]] 2gm IV q4h
;CSF leak with closed head trauma
*[[Ceftriaxone]] 2gm IV q12hr + [[vancomycin]] 15mg/kg q8-12hr
;Penetrating head injury (or recent surgery)
*([[Ceftazidime]] 2gm IV q8hr or [[cefepime]] or [[meropenem]]) + [[vanco]] 25 milligrams/kg load
;Meningitis due to [[Sinusitis]]
*[[Ceftriaxone]] + [[Metronidazole]]
;Meningitis with severe PCN allergy
*[[Chloramphenicol]] 1g IV q6h + [[vancomycin]] 15mg/kg q8-12hr

Revision as of 22:02, 6 April 2015

treatment guidelines based on van de Beek et al[1]

Neonates (up to 1 month of age)

MRSA is uncommon in the neonate

> 1 month to Adult

Vancomycin is for resistant [Pneumococcus]])

Post Procedural (or penetrating trauma)

Cryptococcosis Meningitis

Options

  • Amphotericine B 1mg/kg IV once daily AND Fluctosine 25mg/kg PO q6hrs daily
  • Amphotericine B 5mg/kg IV once daily AND Flucytosine 25mg/kg PO q6hrs daily

Neisseria meningitidis Prophylaxis

  • [[Ceftriaxone 250mg IM once (if less than 15yo 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

Meningitis with severe PCN allergy

Age >50y

  1. ↑ van de Beek D. et al. Advances in treatment of bacterial meningitis. Lancet. Nov 10 2012;380(9854):1693-702
Retrieved from "https://www.wikem.org/w/index.php?title=Template:Meningitis_Antibiotics&oldid=35630"