Meningitis: Post neurosurgical infection
Consult Paediatric ID.
Modify treatment following susceptibility results.
Preferred including non-severe penicillin allergy
ceftriaxone 100mg/kg (Max 4g) iv OD
AND metronidazole iv (see dosing table below) if primary surgery penetrated sinuses
AND vancomycin iv
metronidazole IV dosing information:
|
Age |
metronidazole IV dose |
|
1 month up to 2 months |
Loading dose 15 mg/kg (Max 500mg) iv, then (after 8 hours) 7.5 mg/kg (Max 500mg) iv TDS |
|
2 months to 17 years |
7.5mg/kg (max 500mg) iv TDS |
Alternative
For severe penicillin allergy
ciprofloxacin* 10mg/kg (Max 400mg) iv TDS * ciprofloxacin may induce convulsions in patients with or without a history of convulsions – use with caution
AND metronidazole iv (see dosing table below) if primary surgery penetrated sinuses
AND vancomycin iv
metronidazole IV dosing information:
|
Age |
metronidazole IV dose |
|
1 month up to 2 months |
Loading dose 15 mg/kg (Max 500mg) iv, then (after 8 hours) 7.5 mg/kg (Max 500mg) iv TDS |
|
2 months to 17 years |
7.5mg/kg (Max 500mg) iv TDS |