Meningitis: post-neurosurgical infection
- Cerebrospinal fluid should be sent for microscopy and culture.
- Modify treatment according to sensitivity test results.
Treat for a minimum of 7 days.
Preferred (including penicillin allergy non-severe)
ceftazidime 2g iv tds (If patient is over 80 years of age the usual daily maximum dose of ceftazidime is 3g; this can be increased to 6g daily on advice documented by Micro/ID Consultant)
AND
linezolid 600mg po bd (iv if NBM) (See linezolid drug monograph for information about monitoring required)
If unable to have linezolid: substitute linezolid with vancomycin iv
Alternative
For penicillin allergy (severe)
ciprofloxacin* 400mg iv bd (500mg po bd) Ciprofloxacin may induce seizures in patients with or without a history of seizures – use with caution
AND
linezolid 600mg po bd (iv if NBM) (See linezolid drug monograph for information about monitoring required)
If unable to have linezolid: substitute linezolid with vancomycin iv
*Ensure that the patient is given the Fluoroquinolone MHRA patient information leaflet.
Fluoroquinolones, including ciprofloxacin, are associated with disabling and potentially long-lasting or irreversible side effects. See Fluoroquinolone antibiotics - severe adverse effects.