Bacterial meningitis (IDSA 2004): Difference between revisions
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+ | !Antimicrobial therapy |
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+ | |Age |
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+ | |<1 month |
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+ | |GBS, E.coli, Listeria, Klebsiella |
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+ | |amp + cefotax, or<br />amp + AG |
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+ | |1-23 months |
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+ | |S.pneumo, N.mening, GBS, H.flu, E.coli |
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+ | |vanco + 3G ceph |
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+ | |2-50 years |
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+ | |N.mening, S.pneumo |
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+ | |vanco + 3G ceph |
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+ | |>50 years |
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+ | |S.pneumo, N.mining, Listeria, GNBs |
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+ | |vanco + 3G ceph + amp |
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+ | |Head trauma |
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+ | |Basilar skull fracture |
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+ | |S.pneumo, H.flu, GAS |
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+ | |vanco + 3G ceph |
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+ | |Penetrating trauma |
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+ | |Staph.aureus, CoNS, GNBs |
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+ | |vanco + cefep, or<br />vanco + ceftaz, or<br />vanco + mero |
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+ | |Post-neurosurgery |
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+ | |GNBs, Staph.aureus, CoNS |
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+ | |vanco + cefep, or<br />vanco + ceftaz, or<br />vanco + mero |
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+ | |CSF shunt |
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+ | |CoNS, Staph,aureus, GNBs, P.acnes |
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+ | |vanco + cefep, or<br />vanco + ceftaz, or<br />vanco + mero |
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Revision as of 10:49, 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 | GBS, E.coli, Listeria, Klebsiella | amp + cefotax, or amp + AG |
1-23 months | S.pneumo, N.mening, GBS, H.flu, E.coli | vanco + 3G ceph |
2-50 years | N.mening, S.pneumo | vanco + 3G ceph |
>50 years | S.pneumo, N.mining, Listeria, GNBs | vanco + 3G ceph + amp |
Head trauma | ||
Basilar skull fracture | S.pneumo, H.flu, GAS | vanco + 3G ceph |
Penetrating trauma | Staph.aureus, CoNS, GNBs | vanco + cefep, or vanco + ceftaz, or vanco + mero |
Post-neurosurgery | GNBs, Staph.aureus, CoNS | vanco + cefep, or vanco + ceftaz, or vanco + mero |
CSF shunt | CoNS, Staph,aureus, GNBs, P.acnes | vanco + cefep, or vanco + ceftaz, or vanco + mero |