Template:Meningitis Antibiotics: Difference between revisions

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''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>
====Neonates (up to 1 month of age)<ref>van de Beek D. et al. Advances in treatment of bacterial meningitis. Lancet. Nov 10 2012;380(9854):1693-702</ref>====
===Neonates (up to 1 month of age)===
{{Neonatal meningitis antibiotics}}
{{Neonatal meningitis antibiotics}}


===> 1 month to Adult===
====> 1 month old<ref>van de Beek D. et al. Advances in treatment of bacterial meningitis. Lancet. Nov 10 2012;380(9854):1693-702</ref>====
*[[Ceftriaxone]] 2gm (50mg/kg) IV BID daily '''PLUS'''
{{Pediatric meningitis antibiotics}}
*[[Vancomycin]] 15-20 mg/kg IV BID daily
**'''[[Vancomycin]] is for resistant [[Pneumococcus]]'''


===> 50 yoa===
====Adult < 50 yr<ref>van de Beek D. et al. Advances in treatment of bacterial meningitis. Lancet. Nov 10 2012;380(9854):1693-702</ref>====
*[[Ceftriaxone]] 2gm (50mg/kg) IV BID daily '''PLUS'''
{{Young adult meningitis antibiotics}}
*[[Vancomycin]] 15-20 mg/kg IV BID daily '''PLUS'''
*Ampicillin 2 g q4h (hourly if listeria suspected)<ref>[Guideline] Chaudhuri A, Martinez-Martin P, Kennedy PG, et al. EFNS guideline on the management of community-acquired bacterial meningitis: report of an EFNS Task Force on acute bacterial meningitis in older children and adults. Eur J Neurol. 2008 Jul. 15(7):649-59.</ref>


===Post Procedural (or penetrating trauma)===
====Adult > 50 yr and Immunocompromised<ref>van de Beek D. et al. Advances in treatment of bacterial meningitis. Lancet. Nov 10 2012;380(9854):1693-702</ref>====
{{Elderly adult meningitis antibiotics}}
 
====Post Procedural (or penetrating trauma)<ref>van de Beek D. et al. Advances in treatment of bacterial meningitis. Lancet. Nov 10 2012;380(9854):1693-702</ref>====
*[[Vancomycin]] 15-20mg/kg IV BID daily '''PLUS'''
*[[Vancomycin]] 15-20mg/kg IV BID daily '''PLUS'''
*[[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
*[[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====
{{Crypto meningitis antibiotics}}


===[[Cryptococcosis]] Meningitis===
====Meningitis with severe PCN allergy====
'''Options'''
{{Meningitis peniccillin allergic antibiotics}}
*Amphotericin B 1mg/kg IV once daily '''AND''' Flucytosine 25mg/kg PO q6hrs daily
*Amphotericin B 5mg/kg IV once daily '''AND''' Flucytosine 25mg/kg PO q6hrs daily


====Meningitis with VP shunt====
*Coverage for skin contaminants ([[S. epidermis]], [[S. aureus]])
*[[Vancomycin]] plus [[ceftriaxone]] plus shunt removal


===[[Neisseria meningitidis]] Prophylaxis===
===[[Neisseria meningitidis]] Prophylaxis===
*[[Ceftriaxone]] 250mg IM once (if less than 15yr then 125mg IM)
{{Neisseria meningitis prophylaxis}}
*[[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

Latest revision as of 05:07, 23 November 2018

Neonates (up to 1 month of age)[1]

MRSA is uncommon in the neonate

> 1 month old[3]

Adult < 50 yr[4]

Adult > 50 yr and Immunocompromised[5]

Post Procedural (or penetrating trauma)[7]

Cryptococcosis Meningitis

Options

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

Meningitis with severe PCN allergy

Meningitis with VP shunt

Neisseria meningitidis 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
  1. van de Beek D. et al. Advances in treatment of bacterial meningitis. Lancet. Nov 10 2012;380(9854):1693-702
  2. https://www.aappublications.org/content/early/2015/02/25/aapnews.20150225-1
  3. van de Beek D. et al. Advances in treatment of bacterial meningitis. Lancet. Nov 10 2012;380(9854):1693-702
  4. van de Beek D. et al. Advances in treatment of bacterial meningitis. Lancet. Nov 10 2012;380(9854):1693-702
  5. van de Beek D. et al. Advances in treatment of bacterial meningitis. Lancet. Nov 10 2012;380(9854):1693-702
  6. [Guideline] Chaudhuri A, Martinez-Martin P, Kennedy PG, et al. EFNS guideline on the management of community-acquired bacterial meningitis: report of an EFNS Task Force on acute bacterial meningitis in older children and adults. Eur J Neurol. 2008 Jul. 15(7):649-59.
  7. van de Beek D. et al. Advances in treatment of bacterial meningitis. Lancet. Nov 10 2012;380(9854):1693-702