Page 218 - HPP ANTIMICROBIAL GUIDELINE 2018
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CENTRAL NERVOUS INFECTIONS

                        Infection/Condition                                Suggested Treatment                                      Comments
                                                               Preferred                         Alternative

                 Meningitis


                 Empirical treatment               Ceftriaxone 50-75mg/kg IV q12-24h   Cefotaxime 50mg/kg IV q4-6h       Prophylaxis for all household
                                                   for 10-14 days.                                                       contacts if there are unimmunised or
                                                                                      PLUS                               partially immunised children < 4
                                                   If < 3 month-old,                  Vancomycin 15mg/kg IV q6h          years old.
                                                   Ampicillin 50mg/kg IV q4-6h                                           (H influenza and N meningitides
                                                                                                                         meningitis)
                                                   PLUS
                                                   Cefotaxime 50mg/kg IV q4-6h                                           TDM trough target 15-20 g/mL


                 Haemophilus influenza             Ceftriaxone 50-75mg/kg IV q12-24h
                                                   for 10-14 days.


                 Streptococcus pneumoniae          Benzylpenicillin 250,000-400,000
                 MIC < 0.1mcg/mL:                  iu/kg/day IV q4-6h

                                                   Ceftriaxone 50mg/kg IV q12h
                 MIC 0.1-1 mcg/mL:
                                                   Vancomycin IV 15mg/kg IV q6h
                 MIC ≥ 2mcg/mL:
                                                   PLUS
                                                   Ceftriaxone 50mg/kg IV q12h


                 Neisseria meningitidis            Benzylpenicillin 50mg/kg IV q4-6h   Ceftriaxone 50-75mg/kg IV q12-24h   Prophylaxis for all household
                                                   for 7 days                         for 7 days.                        contacts and health care workers
                                                                                                                         involved in intubation and suctioning
                                                                                                                         of airway




               HPP AMG                                                    Central Nervous Infection                                                     104
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