Meningitis (1 month and over)
Preferred including penicillin allergy non-severe
cefotaxime 50mg/kg iv bolus (Max 4g) initially in ED
then EITHER:
- continue cefotaxime 50mg/kg (Max 4g) iv QDS (Max per day 12g) OR
- If stable on the ward AND 41 weeks or over corrected gestational age AND NOT receiving iv calcium, change to ceftriaxone 100mg/kg (max 4g) iv OD
Consider need for corticosteroids and aciclovir
For MRSA positive patients: ADD vancomycin iv
For penicillin allergy (severe)
ciprofloxacin* 10mg/kg (Max 400mg) iv TDS AND vancomycin iv
OR
chloramphenicol 25mg/kg iv single dose (Max 1g) THEN consult Paediatric ID/Micro
For MRSA positive patients:
ciprofloxacin* 10mg/kg (Max 400mg) iv TDS AND vancomycin iv
* Note: Ciprofloxacin may induce convulsions in patients with or without a history of convulsions – use with caution
Also Note: If patient is prescribed ciprofloxacin ensure that the patient is given the Fluoroquinolone MHRA patient information leaflet.
For more information about MHRA safety alerts and patient or carer counselling See Fluoroquinolone antibiotics - paediatric position statement