MENINGITIS MANAGEMENT

Explore comprehensive guidelines for Meningitis Management across diverse patient profiles, including those under 50 with normal immunity, individuals above 50 with normal immunity, immunocompromised patients, and cases involving head trauma, penetration, or neurosurgery.

<50, immunocompetent

Ceftriaxone 2gm iv q12h OR Chloramphenicol 1 gm IV q6h OR Ciprofloxacin 400 mg IV q8h

Covers Strep pneumoniae (gram positive cocci), Neisseria Meningitidis(gram negative cocci), Hemophilus influenzae (gram negative coccobacilli)

Vancomycin 1gm iv q12 OR Linezolid 600mg IV q12

Covers Strep pneumoniae

>50 immunocompetent

Ceftriaxone 2gm iv q12h OR Chloramphenicol 1 gm IV q6h OR Ciprofloxacin 400 mg IV q8h

Strep pneumoniae, Neisseria Meningitidis, Hemophilus influenzae

Vancomycin 1gm iv q12 OR Linezolid 600mg IV q12

Strep pneumoniae

Ampicillin 2gm iv q4h OR TMP/ SMX (Bactrim) 7.5mg/kg q12h

Listeria (gram + bacilli)

Immunocompromised

Cefepime 2 gm IV q8h OR Meropenem 2gm IV q 8h OR [ Cipro 400 mg IV q8h and Gentamicin 1mg/kg IV q8h ]

Gram neg bacilli: Pseudomonas, Strep pneumoniae

Vancomycin 1gm iv q12 OR Linezolid 600mg IV q12

Strep pneumoniae

Ampicillin 2gm iv q4h OR TMP/ SMX (Bactrim) 7.5mg/kg q12h

Listeria (gram + bacilli)

Head trauma penetrating, or neurosurgery

Cefepime (4th gen) 2 gm IV q8h OR Meropenem 2gm IV q 8h OR Cipro 400 mg IV q8h and Gentamicin 1mg/kg IV q8h

Gram neg bacilli: Pseudomonas, Strept pneumoniae

Vancomycin 1gm iv q12 OR Linezolid 600mg IV q12

Strep pneumoniae, Staph aureus, staph epidermidis

Infected Shunt

Vancomycin 1gm iv q12 OR Linezolid 600mg IV q12

Staph aureus, staph epidermidis

Cefepime (4th gen) 2 gm IV q8h OR Meropenem 2gm IV q 8h OR Cipro 400 mg IV q8h and Gentamicin 1mg/kg IV q8h

Gram neg bacilli (RARE IN INFECTED SHUNT) : Pseudomonas, Strept pneumoniae

Policy on steroid use

Dexamethasone 0.15mg/kg iv q6h x 3 days first dose 20 minutes before first dose of AB. Continue only for gram positive diplococci, ie Strep pneumoniae