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Guidelines
Pathogens
Antimicrobials
Bacterial meningitis is a medical emergency. Antibiotics should be started as soon as the possibility of bacterial meningitis becomes evident.
Do not wait for CT scan or LP results to start antibiotics. If LP must be delayed, get blood cultures and start therapy.
Antibiotic doses are higher for CNS infections. See specific dosing sections below.
Immunocompetent < 50 years old
Immunocompetent > 50 years old
Immunocompromised
HIV or AIDS
Receipt of immunosuppressive therapy
Transplantation
In patients with HIV infection, non-bacterial causes of meningitis must be considered particularly cryptococcal meningitis.
Infectious Diseases consult is recommended.
Post-Neurosurgery
Dexamethasone
Duration of therapy