Page 219 - HPP ANTIMICROBIAL GUIDELINE 2018

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