Bacterial Meningitis
<1 month of age:
Streptococcus agalactiae (GBS), E. coli, Listeria monocytogenes
>1 month of age:
S. pneumoniae, Neisseria meningitidis, H. influenza, late onset S. agalactiae
</=44 weeks PMA or 0-28 days old:
Ampicillin:
PNA ≤7 days: 300 mg/kg/day IV div q8h
PNA >7 days: 300 mg/kg/day IV div q6h
AND
Ceftazidime:
PNA ≤7 days: 100-150 mg/kg/day IV div q8h
PNA >7 days: 150 mg/kg/day IV div q8h¹
>44 weeks PMA and >28 days of age:
Ceftriaxone 100mg/kg/day IV div q12h (max 4000mg/day)
AND
Vancomycin IV [see dosing recommendations in Bugs and Drugs Section]¹
Empiric Therapy & Alternative Regimens
Duration of Therapy & Clinical Pearls
Consult Infectious Diseases.
CSF Gram-stain, culture, cell count, glucose, and protein, as well as a blood culture should be obtained prior to antibiotic administration if it is felt to be safe to do so for the patient.
Diagnostic Approach to Suspected Bacterial Meningitis and CSF Study Interpretation¹²
Length of Therapy:
Depends on organism isolated, discuss with Infectious Diseases.