Streptococcus pneumoniae (Adults)

Duration of Therapy

10-14 Days

If Penicillin MIC less than or equal to 0.06 mcg/mL

Penicillin G, 4 million units IV q4h

If Penicillin MIC greater than or equal to 0.12 mcg/mL AND Ceftriaxone MIC less than 1 mcg/mL

Ceftriaxone 2g IV q12h

If Penicillin MIC greater than or equal to 0.12 mcg/mL AND Ceftriaxone MIC greater than or equal to 1 mcg/mL

Ceftriaxone 2g IV q12h

PLUS

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

Beta-lactam Allergy

Moxifloxacin 400mg IV q24h

Penicillin/Beta-lactam Allergy

If the patient has a true history of IgE mediated penicillin or beta-lactam allergy, the risks versus benefit of empiric treatment of suspected meningitis with appropriate antimicrobials should be discussed.