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
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 |
* 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