Spectrum: Local Antimicrobial Stewardship, for Eastern Health

Community Acquired Acute Meningitis Duration of Therapy

Recommended Duration

7 days

Excluded Patients

Includes Children only
(Infectious disease consultation strongly recommended)

Only:

  • N. meningiditis

  • H. influenzae

  • S. pneumoniae

Additional Notes

  • There are no data to support a duration recommendation in adults

  • There is a single meta-analysis comparing

short and long durations for community acquired meningitis (N. meningiditis, S. pneumoniae, and H. influenzae) in children, which shows no difference in numerous outcomes (mortality is excluded because of the low number of events in all studies)

  • Durations of therapy for other organisms should be based on clinical improvement and other indicators

  • Adapted from AMMI Canada Position Statement on the Appropriate Duration of Antimicrobial Therapy (2018)

More Information

References
  1. Karageopolous D, Valkimadi P, Kapaskelis A et al., Short versus long duration of antibiotic therapy for bacterial meningitis: a meta-analysis of randomised controlled trials in children, Arch Dis Child, 94:607–614. 2009