Antibiotics for confirmed meningitis
- Meningococcus: IV Ceftriaxone for 7 days
- H influenzae: IV Ceftriaxone for 10 days
- S pneumoniae: IV Ceftriaxone for 14 days, add vancomycin if resistant strain.
- Group B Strep: IV Cefotaxime for at least 14 days.
- L monocytogenes: IV amoxicillin or ampicillin for 21 days in total, plus IV gentamicin for at least the first 7 days.
- Gram-negative bacilli: IV cefotaxime for at least 21 days (unless alternative directed by local antimicrobial resistance patterns or specific sensitivities).
Duration may be dictated by clinical response – discuss with infectious disease specialist.
Long-term management:
- Before discharge consider need for aftercare, discuss potential long-term effects with parents, arrange hearing test.
- Refer children with severe or profound deafness for cochlear implant assessment ASAP.
- Use Meningitis Research Foundation (2020) Discharge checklist.
- Provide MRF (2019) Your guide and direct to meningitis support organisations MRF (2022) After effects or Meningitis Now (n.d.) Your guide and my journal.
- Offer further care on discharge as needed.
- Paediatrician to review child with results of their hearing test 4-6weeks after discharge from hospital considering all potential morbidities and offer referral.
- Inform GP, health visitor or school nurse.
- Notify public health
- Follow up prophylaxis for household contacts. See MRF (2018) Management of meningococcal disease in children and young people.