HTHSCI 2HH3 Quiz: Bacterial Meningitis - TREATMENT Summary Notes
27 Mar 2018
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Because bacterial meningitis is a medical emergency, suspicion warrants empiric therapy with broad-spectrum antibiotics; this is given before the organism is known and once culture results are available, treatment should be modified if needed. The empiric therapy should include coverage for penicillin-resistant s. pneumoniae and n. meningitidis. Justin was immediately given steroids, most likely dexamethasone, in addition to the abx ampicillin, vancomycin and cefotaxime as the empiric therapy. Appropriate regimen for suspected meningitis includes vancomycin (covers abr organisms) and third-generation cephalosporin (cefotaxime); some strains of hib may also be susceptible to ampicillin, so we can throw that on board initially. Dexamethasone, as we know is an immunosuppressant, and so decreases the inflammatory response and has been proven to reduce the rate of hearing loss and other neurological complications associated with meningitis. However, it has not been shown to reduce mortality and should be given prior to or along with abx to have the most benefit.
