Guideline Use

Utilize the Severe Sepsis/Septic Shock guidelines

Dose recommendations are based on patients with normal renal function. Refer to dosing in renal impairment

These guidelines may not be appropriate for patients with a history of multi-drug resistant organisms. Consider infectious disease consultation


If Bacterial Meningitis Suspected

  • Empiric antibiotics should be started immediately (antimicrobial therapy should not be delayed if unable to obtain a Lumbar Puncture or while awaiting results of head CT)
  • ID consult is recommended
  • CSF cytology, gram stain, and culture (culture yield <20% post antibiotics)
  • CSF HSV PCR if c/f viral encephalitis

Note: ventriculitis may demonstrate normal cytology

Management Considerations

  • Empiric therapy should not be unreasonably delayed pending results of head CT or lumbar puncture
  • If an LP is delayed, obtain blood cultures and initiate antimicrobial therapy

Infectious Diseases Consultation is strongly recommended

Additional Information

These recommendations are meant to guide empiric therapeutic decision making and are not meant to replace sound clinical decision making. Definitive therapy should be based on culture and susceptibility reports

  • Rebekah Gass, MD
  • Kyle D. Massey, PharmD