Antibiotic Therapy

Initial Empiric Regimen

Ceftriaxone 2g IV q12h

AND

Vancomycin 25-30 mg/kg IV loading dose x 1 followed by 15-20 mg/kg IV q8h

AND

Dexamethasone 10 mg IV q6h x2-4d in adults. Give 15-20 minutes before or with the first dose of antibiotics. Discontinue if no evidence of pneumococcal meningitis ª ᵇ

+ / -

For patients who have risk factors for Listeria meningitis:

Ampicillin 2g IV q4h

For Serious β-lactam Allergy

Meropenem 2g IV q8h

AND

Vancomycin 25-30 mg/kg IV loading dose x 1 followed by 15-20 mg/kg IV q8h

AND

Dexamethasone 10 mg IV q6h x2-4d in adults Give 15-20 minutes before or with the first dose of antibiotics. Discontinue if no evidence of pneumococcal meningitis ª ᵇ

+ / -

For patients who have risk factors for Listeria meningitis:

Trimethoprim-sulfamethoxazole 20 mg/kg IV divided q6h