- 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
OR
Ceftriaxone 2 g 12 hourly
OR
Ceftriaxone 2 g 12 hourly
Chloramphenicol 25 mg/kg 6 hourly
Adults ≥60 years of age
Cefotaxime 2 g 6 hourly
OR
Ceftriaxone 2 g 12 hourly
AND
Amoxicillin 2 g 4 hourly
OR
Ceftriaxone 2 g 12 hourly
AND
Amoxicillin 2 g 4 hourly
Chloramphenicol 25 mg/kg 6 hourly
AND
Co-trimoxazole 10-20 mg/kg (of the trimethoprim component) in four divided dose
AND
Co-trimoxazole 10-20 mg/kg (of the trimethoprim component) in four divided dose
- IV Vancomycin (15-20 mg/kg bd) or Rifampicin (600 mg bd) should be added if penicillin resistance is suspected (e.g. patient has recently arrived from a country with high rates of resistance)