Bacterial Meningitis

Causative organisms

Diagnostic features

+/-

Assessment - risk stratification

* pre-verbal children present with non-specific features

  High Moderate Low
Headache +++ ++ +
Photophobia +++ ++ +
Fever
Mentation Impaired Normal Normal
Perfusion Impaired Normal Normal

Management

High risk

Moderate risk

Low risk

Do not perform LP if GCS < 15 or focal neurological signs

Antibiotic therapy (see Antibiotic guidelines)

Empiric - Pre-hospital

Empiric - Hospital

+/-

Specific therapy

Organism First line Alternative
Meningococcus IV penicillin 60g/kg (up to 1.8g) 6/24  IV ceftriaxone 50g/kg (up to 2g)  6/24
Pneumococci IV penicillin 60g/kg (up to 1.8g) 6/24
Haemophilus IV ampicillin 60mg/kg (up to 2g)  IV ceftriaxone 50g/kg (up to 2g)  6/24
Listeria IV cotrimoxazole 5/25 mg/kg (up to 160/800mg) 6/24
IV penicillin 60g/kg (up to 1.8g) 6/24 
IV cotrimoxazole 5/25 mg/kg (up to 160/800mg) 6/24
IV ampicillin 60mg/kg (up to 2g)