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18 Cards in this Set
- Front
- Back
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General bacterial meningitis guidlines
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IV, max dose
prefer -cidal Fast, appropriate care! |
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Which Abx's penetrate into CSF?
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3/4 gen cephlosporins
peniciliin ampicillin vancomycin TMP/SMX FQs Metro |
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<1 mo of age; bgus and empiric therapy
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S. agalactiae, E. coli, L monocytogenes, Klebsiella
Tx: Amp + genta (no BBB), or amp + cefotaxime (NO CEFTRIAXONE)) |
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1-23 mo of age; bugs
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s. pneumo, N mening, S. agalact, H. influenza, E. coli
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1-23 mo Tx
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Vanco + 3rd gen cepalosporin (ceftriaxone)
Vanco added to cover possbile resistant step pneumo |
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2-50 years bugs
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n. meningitidis, s. pneumo
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2-50 years Abx
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3rd gen ceph + vanco
AND dexamehtasone |
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What is dexamethason for and how used?
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purpose: decrease inflammation in subarachnoid space, decrease neurologic sequelae
give PRIOR to first Abx dose(steroid) |
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>50 years bugs
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s. pneumo, n. meningitidi, L. monocytogenes, gram negs
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> 50 years Abx
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vancomycin + 3rds gen ceph + ampicillin
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Why do we use vanco in meningitis inf?
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cover for ceftri-resistant s. pneumo
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Duration of Tx for bact meningitis?
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varies by bug: 7-21 days
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prophylaxis for N. meningitidis
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(those exposed)
cipro 500 mg x 1 |
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prophylaxis for h. influenzae
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(everyone in house w/ unvaccinated kids)
rifampin |
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crypococcal meningitis: cns infection
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lipid amphotericin B + flucytosine (synergy) x 2 weeks
THEN fluconazole 400 mg daily x 8 weeks |
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blastomycoses and histoplasmosis cns infection
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lipid amphotericin B 4-6 weeks THEN
oral azole (flu, itra, vori) x 12 months (ass. w/ relapse) |
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coccidiomycoses cns
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high dose (800 mg) fluconazole
(many clinicians will give Ampho B) |
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CSF SHunt infections
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Think skin bugs: gram positives
(staph) Treat broad spectrum: vanco + cefepime or pip/tazo |
