Lumbar puncture contraindicated

Commence empiric antibiotics for suspected meningitis without delay:

Children under 3 months:

  •  IV cefotaxime and either amoxicillin or ampicillin (can replace cefotaxime with ceftriaxone if no contraindication)
  • Add vancomycin if recently overseas or prolonged or multiple antibiotic exposure within the last three months.

Children 3 months and over:

  • IV ceftriaxone unless contraindicated
  • Add vancomycin if recently overseas or prolonged or multiple antibiotic exposure within the last three months.

Contraindications to ceftriaxone: premature neonates with corrected gestational age under 41 weeks and other neonates under 1 month old, particularly those with jaundice, hypoalbuminemia, or acidosis; or receiving concomitant treatment with intravenous calcium.

Perform delayed lumbar puncture in children with suspected bacterial meningitis when contraindications are no longer present (link back into pathway)