| Infection |
|
Meningitis - non-pregnant adults 16-54 years old
|
| Antibiotic Therapy (before prescribing, carefully read the Notes / Comments section below) |
|
Ceftriaxone IV 2g 12 hourly
If penicillin / beta-lactam anaphylaxis:
Chloramphenicol - follow Scottish Antimicrobial Prescribing Group guidance on chloramphenicol dosing.
In pregnancy, the use of chloramphenicol is contraindicated in the 3rd trimester - discuss appropriate empirical choices with an infection specialist.
|
| Duration |
|
Depends on the causative organism
- Neisseria meningitidis - 7 days
- Streptococcus pneumoniae - 14 days
|
| Notes / Comments |
- Neisseria meningitidis ("meningococcus") and Streptococcus pneumoniae are the most common causes of bacterial meningitis in younger adults without immunocompromise.
- Ceftriaxone, while being a 4C-agent, provides reliable cover for these organisms. Chloramphenicol has bactericidal activity for both organisms, but should be reserved for use in patients with penicillin anaphylaxis due to an unfavourable side effect profile.
- If pneumococcal meningitis is suspected, consider adjunctive treatment with dexamethasone, preferably starting before or with first dose of antibacterial, but no later than 12 hours after starting antibacterial treatment. Avoid dexamethasone in septic shock, meningococcal septicaemia, if immunocompromised or in meningitis following surgery.
- Discuss management of suspected meningitis after neurosurgery with an infection specialist.
|
