Severity(classification)

1st line oral/iv antibiotics

Penicillin allergy
(see explanatory notes)

A/B/C

Grading not applicable

Meningitis
Consider Critical Care/Neurology review

DEXAMETHASONE 10mg iv every 6 hours for 4 days
          Started with or just before the first dose of antibiotic(s)
plus
CEFTRIAXONE 2g iv every 12 hours for complete course

• If patient:
  • >50 years
  • immunocompromised
  • alcoholic
  • diabetic
  • pregnant

ADD:
AMOXICILLIN 2g iv every 4 hours

Continue for a minimum of 5 days antibiotic treatment then discuss with microbiologist. Significant microbiology results should be used to refine treatment after discussion

DISCUSS WITH MICROBIOLOGIST

A/B/C

Grading not applicable

Viral Meningo Encephalitis
If suspected Viral meningo encephalitis e.g. due to Herpes simplex or Varicella-zoster, use:
ACICLOVIR 10mg/kg iv every 8 hours for 10 - 21 days

Not Applicable