Table 4 Initial treatment of purulent meningitis with negative direct examination, according to predisposing factors and/or signs of severity [1]
Patient | Suspected organisms | Treatment (posology) |
|---|---|---|
Child | Neisseria meningitidis | Amoxicillin or 3-GC |
| Â | Streptococcus pneumoniae | 3-GC + vancomycin |
| Â | Haemophilus influenzae | 40-60 mg/kg per day. Four infusions = 1 h or continuous infusion |
| Â | Â | (load: 15 mg/kg) 3-GC |
Adult | Streptococcus pneumoniae | Preference 3-GC |
| Â | If suspicion of penicillin-resistant pneumococci and/or signs of severity | 3-GC + vancomycin 40-60 mg/kg per day. Four infusions = 1 h or continuous infusion (load: 15 mg/kg) |
| Â | Listeria monocytogenes | Amoxicillin is indispensable in association with gentamicin or co trimoxazole |
| Â | Neisseria meningitidis | Amoxicillin or 3-GC |
Child and adult | Absence of predisposing factors and signs of severity | Amoxicillin + 3-GC |