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
|
