Guidelines
Community-onset Bacterial Meningitis

Community-onset Bacterial Meningitis

Microbiology

Empiric Treatment (All Patients >28 Days Old)

PLUS

If concerned/risk factors for Listeria monocytogenes ADD

Max: 2 g/dose

  • Vancomycin does NOT provide optimal coverage for Listeria sp.

Duration

S. agalactiae (Group B streptococcus): 14 - 21 days

N. meningitidis: 7 days

S. pneumoniae: 10 - 14 days

Listeria sp: At least 21 days and 2 weeks from last positive culture (whichever is longer)

Gram negative: In the neonate, 2 weeks beyond the first sterile CSF culture or ≥ 3 weeks, whichever is longer

Additional Considerations

Infectious Diseases Consult is recommended

Narrow empiric therapy based upon culture results

If unable to obtain LP prior to beginning antibiotics, consider CNS Biofire (multiplex PCR testing) as PCR will remain positive for some time after antibiotics/antivirals have been started

Max dose provided for drugs with therapeutic drug monitoring can be higher than provided once individual labs available

More information available IDSA Guidelines or ESCMID Guidelines