Page 64 - HPP ANTIMICROBIAL GUIDELINE 2018
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Suggested Treatment
                       Infection/ Condition                                                                                         Comments
                                                               Preferred                         Alternative

                 Prophylaxis for household and    Ciprofloxacin 500mg PO as single    Ceftriaxone 250mg IM as single dose  Close contacts are defined as those
                 close contacts of meningococcal  dose                                (especially in pregnancy and       individuals who have had contact for
                 meningitis cases                                                     lactating mothers)                 > 8 hours and within 1 meter of the
                 (age > 12 years)                 OR                                                                     index case. Individuals who were in
                                                  Rifampicin 600mg PO q12h for        OR                                 contact with oropharyngeal
                                                  2 days (4 doses) [not recommended   Azithromycin 500mg PO as single    secretions of the index case in the
                                                  in pregnant women]                  dose.                              last 7 days before onset of
                                                                                                                         symptoms up to 24 hours after
                                                                                                                         appropriate antibiotics should also
                 Prophylaxis for children < 12 years   Ciprofloxacin 250 mg as single dose                               receive chemoprophylaxis.
                                                  (age 5-12 years) or
                                                  125 mg (age < 5 years)                                                 For index case who received only
                                                                                                                         benzylpenicillin as therapy,
                                                  OR                                                                     chemoprophylaxis should also be
                                                  Rifampicin 10 mg/kg q12H for 2 days                                    given upon discharge to eliminate
                                                                                                                         nasopharyngeal carriage


                 Listeriosis                      Ampicillin  2gm IV q4h              Trimethoprim(TMP)/                 Duration of treatment is 3 weeks
                                                  OR                                  Sulfamethoxazole (80/400mg) TMP    depending on clinical response
                                                  Benzylpenicillin 4MU IV q4h         10 to 20 mg/kg/day IV in 4 divided
                                                                                      doses                              Gentamicin is given until symptoms
                                                  PLUS/MINUS                                                             improve (minimum of 1 week)

                                                  Gentamicin 4-7mg/kg/day IV in
                                                  3 divided doses


                 Brain abscess/subdural           Ceftriaxone 2 gm IV q12h            Cefotaxime 2 gm IV q4-6h           Duration to be determined by clinical
                 empyema                                                                                                 response, usually 2-6 weeks.
                                                  PLUS                                PLUS
                                                  Metronidazole 500mg IV q8h          Metronidazole 500mg IV q8h






               HPP AMG                                                   Central Nervous Infections                                                      27
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