Bacterial meningitis (IDSA 2004): Difference between revisions

Latest revision as of 19:51, 2 August 2020

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

@@ Line 10: / Line 10: @@
 !Antimicrobial therapy
 |-
-|Age
+! colspan="3" |Age
-|
-|
 |-
 |&lt;1 month
-|GBS, E.coli, Listeria, Klebsiella
+|[[Group B streptococcus]], [[Escherichia coli]], [[Listeria]], [[Klebsiella]]
 |amp + cefotax, or<br />amp + AG
 |-
 |1-23 months
+|[[Streptococcus pneumoniae]], [[Neisseria meningitidis]], [[Group B streptococcus]], [[Haemophilus influenzae]], [[Escherichia coli]]
-|S.pneumo, N.mening, GBS, H.flu, E.coli
 |vanco + 3G ceph
 |-
 |2-50 years
+|[[Neisseria meningitidis]], [[Streptococcus pneumoniae]]
-|N.mening, S.pneumo
 |vanco + 3G ceph
 |-
 |&gt;50 years
+|[[Streptococcus pneumoniae]], [[Neisseria meningitidis]], [[Listeria]], [[Gram-negative bacilli]]
-|S.pneumo, N.mining, Listeria, GNBs
 |vanco + 3G ceph + amp
 |-
-|Head trauma
+! colspan="3" |Head trauma
-|
-|
 |-
 |Basilar skull fracture
+|[[Streptococcus pneumoniae]], [[Haemophilus influenzae]], [[GAS]]
-|S.pneumo, H.flu, GAS
 |vanco + 3G ceph
 |-
 |Penetrating trauma
+|[[Staphylococcus aureus]], [[coagulase-negative staphylococci]], [[Gram-negative bacilli]]
-|Staph.aureus, CoNS, GNBs
 |vanco + cefep, or<br />vanco + ceftaz, or<br />vanco + mero
 |-
 |Post-neurosurgery
+|[[Gram-negative bacilli]], [[Staphylococcus aureus]], [[coagulase-negative staphylococci]]
-|GNBs, Staph.aureus, CoNS
 |vanco + cefep, or<br />vanco + ceftaz, or<br />vanco + mero
 |-
 |CSF shunt
+|[[Coagulase-negative staphylococci]], [[Staphylococcus aureus]], [[Gram-negative bacilli]], [[Cutibacterium acnes]]
-|CoNS, Staph,aureus, GNBs, P.acnes
 |vanco + cefep, or<br />vanco + ceftaz, or<br />vanco + mero
 |}