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	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