Empiric therapy in otherwise healthy adults should cover streptococcus pneumoniae neisseria meningitidis group b streptococcus and haemophilus influenzae. The infectious diseases society of america idsa recommends that empiric treatment be tailored to the patient s age and comorbidities especially the presence of immunosuppression. The recommended initial treatment for gbs meningitis in neonates 1 wk of age is penicillin g 100 000 units kg iv q 6 h or ampicillin 100 mg kg iv q 8 h for infants 7 days or 75 mg kg q 6 h for infants 7 days.
Initial empiric treatment depends on patient age and is still debated. Not infrequently this form of immunotherapy had untoward immune consequences including serum sickness conjunctival edema and anaphylaxis. The first attempts at treatment which resulted in only modest reductions in the high mortality rate of haemophilus influenzae type b hib meningitis involved the administration of antisera generated by intrathecal inoculation of horses.
A high index of suspicion for meningitis is needed in any unwell child particularly if there is altered mental state or no clear focus. Bacterial meningitis is a medical emergency which requires empiric antibiotic treatment without delay. Estimates based on this prevalence and a population of 2 3 x 10 8 suggest that approximately 23 000 episodes of.
Population studies from three counties indicate that meningitis occurs with a frequency of approximately 10 episodes per 100 000 population annually in the united states. Empiric therapy for bacterial meningitis. May 4 2020 0 comments.
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May 11 2020 0 comments. Acute non bacterial meningitis chronic meningitis empiric antibiotic therapy. Pneumoniae ceftriaxone 2 gm iv q12h x 2 weeks cefotaxime 3 gm iv q6h x 2 weeks or ceftizoxime 3 gm iv q6h x 2 weeks chloramphenicol 500 mg po q6h.
Empiric therapy of cns infections acute bacterial meningitis abm subset usual pathogens preferred iv therapy alternate iv therapy iv to po switch normal host n.
Empiric treatment for meningitis. The empiric therapy recommended by the world health organization for meningococcal meningitis during epidemics is one or two intramuscular injections of long acting chloramphenicol oily suspension although intramuscular ceftriaxone is an acceptable alternative. This is discussed in detail separately. Empiric treatment for meningitis encephalitis with bacterial pattern csf results. Treatment involves a cocktail of several drugs 1 dexamethasone 10 mg iv q6hr for four days.
2 ceftriaxone 2 grams iv q12hr. If the patient has a history of penicillin anaphylaxis or cephalosporin allergy may use meropenem 2g iv q8hr. Guideline for treatment of bacterial meningitis in adults patient population common pathogens empiric treatment regimen duration of therapy comments reference age 18 n. Monocytogenes age 50 aerobic gnr age 50 1st line.
Ceftriaxone 2 g iv q12h.
Ceftriaxone 2 g iv q12h. Monocytogenes age 50 aerobic gnr age 50 1st line. Guideline for treatment of bacterial meningitis in adults patient population common pathogens empiric treatment regimen duration of therapy comments reference age 18 n.
If the patient has a history of penicillin anaphylaxis or cephalosporin allergy may use meropenem 2g iv q8hr. 2 ceftriaxone 2 grams iv q12hr. Treatment involves a cocktail of several drugs 1 dexamethasone 10 mg iv q6hr for four days.
Empiric treatment for meningitis encephalitis with bacterial pattern csf results. This is discussed in detail separately. The empiric therapy recommended by the world health organization for meningococcal meningitis during epidemics is one or two intramuscular injections of long acting chloramphenicol oily suspension although intramuscular ceftriaxone is an acceptable alternative.
