Antibiotics for confirmed meningitis:

• Group B Strep: IV cefotaxime for at least 14 days OR IV benzylpenicillin for at least 14 days plus IV gentamicin for first 5 days
• N. Meningitidis: IV ceftriaxone for 7 days
• H. influenzae: IV ceftriaxone for 10 days
• S. pneumoniae: IV ceftriaxone for 14 days
• L. monocytogenes: IV amoxicillin 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 directed otherwise by antibiotic sensitivities

Duration may be dictated by clinical response, if poor/complicated d/w microbiology or ID expert

Ceftriaxone and cefotaxime are interchangeable.

Contraindications to ceftriaxone: as per BNFc: 

• under 41weeks corrected gestational age
• Neonates over 41weeks corrected gestational age with:
  • jaundice
  • acidosis
  • hypoalbuminaemia
  • simultaneous administration of calcium-containing infusions (inc total parenteral nutrition containing calcium)

Consider ambulatory/home antibiotics in selected cases.

Follow up and long term management:

• Use MRF discharge checklist .
• Before discharge: consider need for after care, discuss potential long-term effects with parents and arrange hearing test within 4 weeks of being fit enough to test.
• Refer severe or profoundly deaf children for cochlear implant assessment ASAP.
• Direct to support organisations such as Meningitis Research Foundation, Meningitis Now & GBS Support.
• Arrange paediatric review with results of hearing test 4-6 weeks after discharge from hospital.
• Consider all potential morbidities at discharge and offer referral.
• Inform GP and health visitor.
• Follow up until at least 2 years of age

Notify public health: see public health guidance for prophylaxis of household contacts

• UK Gov (2022) Meningococcal Disease: guidance, data and analysis. 
• UK Gov (2013). Haemophilus influenzae type b (Hib): recommendations for the prevention of secondary cases.