Meningitis (1 month and over)

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

ciprofloxacin* 10mg/kg (Max 400mg) iv TDS AND vancomycin iv

*ciprofloxacin may induce convulsions in patients with or without a history of convulsions – use with caution

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  

*ciprofloxacin may induce convulsions in patients with or without a history of convulsions – use with caution