Template:Meningitis Antibiotics: Difference between revisions
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===[[Neisseria meningitidis]] Prophylaxis=== | ===[[Neisseria meningitidis]] Prophylaxis=== | ||
*[[Ceftriaxone 250mg IM once (if less than 15yo then 125mg IM) | *[[Ceftriaxone]] 250mg IM once (if less than 15yo then 125mg IM) | ||
*[[Ciprofloxacin]] 500mg PO once | *[[Ciprofloxacin]] 500mg PO once | ||
*[[Rifampin]] 600 mg PO BID x 2 days | *[[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 5mg/kg PO BID x 2 days | ||
** if ≥ 1 month old then 10mg/kg (max at 600mg) 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=== | ===Meningitis with severe PCN allergy=== | ||
Revision as of 22:04, 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
- Ampicillin 50mg/kg IV q6hrs PLUS
- 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
- ↑ van de Beek D. et al. Advances in treatment of bacterial meningitis. Lancet. Nov 10 2012;380(9854):1693-702