Sandbox/20: Difference between revisions
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| '''''1 mo—50 yrs''''' || '''''[[Streptococcus pneumoniae]] <BR> [[Neisseria meningitidis]] <BR> [[Haemophilus influenzae]]<sup>†</sup> || '''''[[Cefotaxime]] 2 gm IV q4—6h''''' ''OR'' '''''[[Ceftriaxone]] 2 gm IV q12h''''' <BR> ''PLUS'' <BR> '''''[[Vancomycin]] 500—750 mg IV q6h'''''<sup>‡</sup> <BR> ''PLUS'' <BR> '''''[[Dexamethasone]]''''' || | | '''''1 mo—50 yrs''''' || '''''[[Streptococcus pneumoniae]] <BR> [[Neisseria meningitidis]] <BR> [[Haemophilus influenzae]]<sup>†</sup> || '''''[[Cefotaxime]] 2 gm IV q4—6h''''' ''OR'' '''''[[Ceftriaxone]] 2 gm IV q12h''''' <BR> ''PLUS'' <BR> '''''[[Vancomycin]] 500—750 mg IV q6h'''''<sup>‡</sup> <BR> ''PLUS'' <BR> '''''[[Dexamethasone]]''''' || | ||
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| | | '''''>50 yrs or alcoholism''''' || 123 || 123 || 123 | ||
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Revision as of 15:22, 13 December 2013
Bacterial Meningitis
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
Diagnosis
- Bacterial meningitis is the infection of meninges by bacteria.
Empiric Therapy
Negative CSF Gram Stain
| Group | Etiology | Preferred Regimen | Alternative Regimen |
| Preterm—1 mo | Streptococcus agalactiae (49%) Escherichia coli (18%) misc. Gram-positive (10%) misc. Gram-negative (10%) Listeria (7%) |
Drug A PLUS Drug B |
Drug C PLUS Drug D |
| 1 mo—50 yrs | Streptococcus pneumoniae Neisseria meningitidis Haemophilus influenzae† |
Cefotaxime 2 gm IV q4—6h OR Ceftriaxone 2 gm IV q12h PLUS Vancomycin 500—750 mg IV q6h‡ PLUS Dexamethasone |
|
| >50 yrs or alcoholism | 123 | 123 | 123 |
† H. influenzae now very rare, listeria unlikely if young & immuno-competent (add ampicillin if suspect listeria: 2 gm IV q4h)
‡ Children’s dosage 15 mg/kg IV q6h (2x standard adult dose)