Bacterial Meningitis / Encephalitis

Duration

Typical duration = up to 10 days.

First Line

Cefotaxime 2g IV 6 x daily ( 4 hourly) for the first 24 hours.

Reducing appropriate to clinical response. Seek Consultant Microbiologist / ID Consultant advice on further treatment

2nd line / Alternative

Consultant microbiologist MUST contacted before prescribing to approve.

Chloramphenicol 25mg / kg IV 6 hourly

WARNING: Associated with serious haematological side effects. Full blood counts required daily during treatment.

Reduce dose as soon as clinically possible

Bacterial Meninigitis > 50 yrs (possible Listeria) or other Listeria risk factors (eg immunocompromised,acId suppression) ADD:

Amoxicillin 2g IV 6 X daily (4 hourly)

Typical duration = up to 14 days.

If meningococcal or penicillin sensitive pneumococcal isolate confirmed change to :

Benzypenicillin 2.4g IV 4 hourly

Typical duration= 10 – 14 days

Encephalitis

Aciclovir 10mg / kg IV 8 hourly

Suspected Herpes simplex virus. Discuss with consultant Microbiologist

Typical duration = 10 - 21 days

Viral Meningitis

NO ANTIBIOTICS NECESSARY

Notes

Suspected meningococcal meningitis is a medical emergency and requires urgent resuscitation and antibiotics. Collect blood  cultures, CSF if possible ,throat swab and EDTA blood meningococcal PCR but do not delay giving antibiotics.

Meningitis should be reported to the duty Public Health Consultant who will give guidance on the necessity of prophylaxis treatment.