Resuscitation & Supportive Management Ensure appropriate staff available to manage patientABC approach treating abnormalities as found:Consider need for intubation for airway protection:Strongly consider if GCS <12Maintain adequate blood pressure aiming MAP...
Antibiotics must penetrate CSF and be given in an appropriate bactericidal dosage Recommended empirical therapy is based upon age given potential causative organisms No Penicillin Allergy Penicillin Allergy Adults <60 years of age Cefotaxime 2 g 6 hourly...
Antibiotic therapy should start as soon as possible in suspected bacterial meningitis (within 1 hour of diagnosis: Delayed administration is strongly associated with death and poor outcome in meningitis Should not be delayed for lumbar puncture or imaging...
Recommended duration of antibiotic therapy depends upon which pathogen is identified. Streptococcus pneumoniae – 10 days if stable (14 days if slow responder or resistant organism) Neisseria meningitides – 5 days Listeria monocytogenes – 21 days...
May reduce mortality though only with certain causative organisms: Significant reduction in death seen in patients with streptococcus pneumoniae meningitis (29.9% versus 36.0%), Not significantly reduced in all-cause meningitis (17.8% versus 19.9%) May improve...
