Bacterial meningitis (IDSA 2004)

Tunkel AR, Hartman BJ, Kaplan SL, Kaufman BA, Roos KL, Scheld WM, Whitley RJ. Practice guidelines for the management of bacterial meningitis. Clin Infect Dis. 2004 Nov 1;39(9):1267-84. Epub 2004 Oct 6. doi: 10.1086/425368

Table 4: Empiric Treatment

Population	Common pathogens	Antimicrobial therapy
Age
<1 month	Group B streptococcus, Escherichia coli, Listeria, Klebsiella	amp + cefotax, or amp + AG
1-23 months	Streptococcus pneumoniae, Neisseria meningitidis, Group B streptococcus, Haemophilus influenzae, Escherichia coli	vanco + 3G ceph
2-50 years	Neisseria meningitidis, Streptococcus pneumoniae	vanco + 3G ceph
>50 years	Streptococcus pneumoniae, Neisseria meningitidis, Listeria, Gram-negative bacilli	vanco + 3G ceph + amp
Head trauma
Basilar skull fracture	Streptococcus pneumoniae, Haemophilus influenzae, GAS	vanco + 3G ceph
Penetrating trauma	Staphylococcus aureus, coagulase-negative staphylococci, Gram-negative bacilli	vanco + cefep, or vanco + ceftaz, or vanco + mero
Post-neurosurgery	Gram-negative bacilli, Staphylococcus aureus, coagulase-negative staphylococci	vanco + cefep, or vanco + ceftaz, or vanco + mero
CSF shunt	Coagulase-negative staphylococci, Staphylococcus aureus, Gram-negative bacilli, Cutibacterium acnes	vanco + cefep, or vanco + ceftaz, or vanco + mero