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{{Reflist|2}}
{{Reflist|2}}


[[Category:Primary care]]
 
[[Category:Disease]]
[[Category:Disease]]



Latest revision as of 06:40, 28 July 2020

Meningitis Main Page

Patient Information

Overview

Causes

Classification

Viral Meningitis
Bacterial Meningitis
Fungal Meningitis

Differential Diagnosis

Diagnosis

Treatment

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Cafer Zorkun, M.D., Ph.D. [2], Sheng Shi, M.D. [3]

Empiric Therapy Adapted from Advances in treatment of bacterial meningitis. Lancet. 2012;380(9854):1693-702.[1]

Community-Acquired Meningitis
Newborn, Age <1 Week
Preferred Regimen
Ampicillin 50 mg/kg IV q8h
AND
Cefotaxime 100—150 mg/kg/day IV q8—12h
Alternative Regimen
Ampicillin 50 mg/kg IV q8h
AND
Gentamicin 2.5 mg/kg IV q12h
Newborn, Age 1—4 Weeks
Preferred Regimen
Ampicillin 200 mg/kg/day IV q6—8h
AND
Cefotaxime 150—200 mg/kg/day IV q6—8h
Alternative Regimen
Ampicillin 200 mg/kg/day IV q6—8h
AND
Gentamicin 2.5 mg/kg IV q8h
OR
Tobramycin2.5 mg/kg IV q8h
OR
Amikacin 10 mg/kg IV q8h
Infant and Children
Preferred Regimen
Vancomycin 15 mg/kg IV q6h
to achieve serum trough concentrations of 15–20 μg/mL
AND
Cefotaxime 225—300 mg/kg/day IV q6–8h
OR
Ceftriaxone 80—100 mg/kg/day IV q12–24h



Adult, Age <50 Years
Preferred Regimen
Vancomycin 30–60 mg/kg/day IV q8–12h
to achieve serum trough concentrations of 15–20 μg/mL
AND
Cefotaxime 8–12 g/day IV q4–6h
OR
Ceftriaxone 2 g IV q12h
Adult, Age >50 Years
Preferred Regimen
Vancomycin 30–60 mg/kg/day IV q8–12h
AND
Ampicillin 2 g IV q4h
AND
Cefotaxime 8–12 g/day IV q4–6h
OR
Ceftriaxone 2 g IV q12h
Immunocompromised
Preferred Regimen
Vancomycin 30–60 mg/kg/day IV q8–12h
AND
Ampicillin 2 g IV q4h
AND
Cefepime 2 g IV q8h
OR
Meropenem 2 g IV q8h
Recurrent
Preferred Regimen
Vancomycin 30—60 mg/kg/day IV q8–12h
AND
Cefotaxime 8–12 g/day IV q4–6h
OR
Ceftriaxone 2 g IV q12h

Add Ampicillin 2 g IV q4h (50 mg/kg IV q6h for children) if meningitis caused by Listeria monocytogenes is also suspected.

Healthcare-Associated Meningitis
Basilar Skull Fracture
Preferred Regimen
Vancomycin 30—60 mg/kg/day IV q8–12h
AND
Cefotaxime 8–12 g/day IV q4–6h
OR
Ceftriaxone 2 g IV q12h


Head Trauma; Post-Neurosurgery
Preferred Regimen
Vancomycin 30—60 mg/kg/day IV q8–12h
AND
Ceftazidime 2 g IV q8 h
OR
Cefepime 2 g IV q8h
OR
Meropenem 2 g IV q8h

References

  1. van de Beek, D.; Brouwer, MC.; Thwaites, GE.; Tunkel, AR. (2012). "Advances in treatment of bacterial meningitis". Lancet. 380 (9854): 1693–702. doi:10.1016/S0140-6736(12)61186-6. PMID 23141618. Unknown parameter |month= ignored (help)