Bacterial meningitis

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  • Before starting treatment make sure to take a CSF sample for Gram staining, CSF analysis, culture, and sensitivity. Adjust the antibiotic management based on the laboratory report.
  • In hospital, start an IV infusion for antibiotics using Dextrose 5% (not more than 50 mL/kg per day for an infant) and continue until oral medication can be tolerated
  • Sometimes corticosteroids may be of help
  • Give antibiotics for at least 14 days, if there is a good response in meningococcal disease stop at 7 days
  • Do a repeat CSF

Treatment

Adults (empirical treatment pending test results)

  • Give Ceftriaxone 2g IV 12 hourly

Alternatively

  • Give Chloramphenicol 1g IV 6 hourly
  • Give Benzyl penicillin 5MU IV 6 hourly

Use the alternative regime only when ceftriaxone is not available and evidence of culture and sensitivity of the invading organism to Chloramphenicol.

Children

  • Give Ceftriaxone 100mg/kg IM or IV 24 hourly for 7 days

Alternatively

  • Chloramphenicol 25mg /kg IV 8 hourly

plus

  • Benzylpenicillin 100,000 IU/kg 6 hourly IV/IM