Central nervous system infections, antibacterial therapy Flashcards
Initial Empirical Therapy for Meningitis:
Q: What is the initial antibiotic treatment for meningococcal disease if suspected, especially with a non-blanching rash or meningococcal septicaemia?
A: Benzylpenicillin sodium. Use cefotaxime as an alternative in penicillin allergy; chloramphenicol may be used if there’s a history of an immediate hypersensitivity reaction to penicillin or cephalosporins.
Q: When should adjunctive treatment with dexamethasone be considered, and when should it be avoided?
A: Consider adjunctive treatment with dexamethasone, preferably starting before or with the first dose of antibacterials, but avoid it in cases of septic shock, meningococcal septicaemia, or if the patient is immunocompromised, or if the meningitis follows surgery.
Q: In the hospital, if the etiology of meningitis is unknown in adults and children aged 3 months to 59 years, what antibiotics should be used?
A: Cefotaxime (or ceftriaxone). Consider adding vancomycin if there’s a history of prolonged or multiple use of other antibacterials in the last 3 months or if the patient has traveled to areas outside the UK with highly penicillin- and cephalosporin-resistant pneumococci.
Q: What’s the suggested duration of treatment for meningitis with an unknown etiology in adults and children aged 3 months to 59 years?
A: At least 10 days.
Q: In the hospital, if the etiology of meningitis is unknown in adults aged 60 years and over, what antibiotics should be used?
A: Cefotaxime (or ceftriaxone) + amoxicillin (or ampicillin). Consider adding vancomycin under the same conditions as mentioned in the previous question.
Q: What’s the suggested duration of treatment for meningitis with an unknown etiology in adults aged 60 years and over?
A: At least 10 days.
Q: How is meningitis caused by meningococci treated, and what’s the suggested duration of treatment?
A: Benzylpenicillin sodium or cefotaxime (or ceftriaxone). The suggested duration of treatment is 7 days. Use chloramphenicol if there’s a history of immediate hypersensitivity reaction to penicillin or cephalosporins.
Q: How is meningitis caused by pneumococci treated, and what adjunctive treatment may be considered?
A: Cefotaxime (or ceftriaxone). Consider adjunctive treatment with dexamethasone, preferably starting before or with the first dose of antibacterial, but no later than 12 hours after starting antibacterial. If the micro-organism is penicillin-sensitive, replace cefotaxime with benzylpenicillin sodium.
Q: What’s the suggested duration of antibacterial treatment for pneumococcal meningitis?
A: 14 days. Add vancomycin and rifampicin if the micro-organism is highly penicillin- and cephalosporin-resistant.
Q: How is meningitis caused by Haemophilus influenzae treated, and what’s the suggested duration of treatment?
A: Cefotaxime (or ceftriaxone). The suggested duration of antibacterial treatment is 10 days.
Q: When should rifampicin be given for H. influenzae type b meningitis, and to whom?
A: Give rifampicin for 4 days before hospital discharge to those under 10 years of age or to those in contact with vulnerable household contacts.
Q: How is meningitis caused by Listeria treated, and what’s the suggested duration of treatment?
A: Amoxicillin (or ampicillin) + gentamicin. The suggested duration of treatment is 21 days, but consider stopping gentamicin after 7 days. Use co-trimoxazole if there’s a history of immediate hypersensitivity reaction to penicillin.
Regenerate
Initial Empirical Therapy for Meningitis:
Q: What is the initial antibiotic treatment for meningococcal disease if suspected, especially with a non-blanching rash or meningococcal septicaemia?
A: Benzylpenicillin sodium. Use cefotaxime as an alternative in penicillin allergy; chloramphenicol may be used if there’s a history of an immediate hypersensitivity reaction to penicillin or cephalosporins.
Q: When should adjunctive treatment with dexamethasone be considered, and when should it be avoided?
A: Consider adjunctive treatment with dexamethasone, preferably starting before or with the first dose of antibacterials, but avoid it in cases of septic shock, meningococcal septicaemia, or if the patient is immunocompromised, or if the meningitis follows surgery.
Q: In the hospital, if the etiology of meningitis is unknown in adults and children aged 3 months to 59 years, what antibiotics should be used?
A: Cefotaxime (or ceftriaxone). Consider adding vancomycin if there’s a history of prolonged or multiple use of other antibacterials in the last 3 months or if the patient has traveled to areas outside the UK with highly penicillin- and cephalosporin-resistant pneumococci.
Q: What’s the suggested duration of treatment for meningitis with an unknown etiology in adults and children aged 3 months to 59 years?
A: At least 10 days.
Q: In the hospital, if the etiology of meningitis is unknown in adults aged 60 years and over, what antibiotics should be used?
A: Cefotaxime (or ceftriaxone) + amoxicillin (or ampicillin). Consider adding vancomycin under the same conditions as mentioned in the previous question.
Q: What’s the suggested duration of treatment for meningitis with an unknown etiology in adults aged 60 years and over?
A: At least 10 days.
Q: How is meningitis caused by meningococci treated, and what’s the suggested duration of treatment?
A: Benzylpenicillin sodium or cefotaxime (or ceftriaxone). The suggested duration of treatment is 7 days. Use chloramphenicol if there’s a history of immediate hypersensitivity reaction to penicillin or cephalosporins.
Q: How is meningitis caused by pneumococci treated, and what adjunctive treatment may be considered?
A: Cefotaxime (or ceftriaxone). Consider adjunctive treatment with dexamethasone, preferably starting before or with the first dose of antibacterial, but no later than 12 hours after starting antibacterial. If the micro-organism is penicillin-sensitive, replace cefotaxime with benzylpenicillin sodium.
Q: What’s the suggested duration of antibacterial treatment for pneumococcal meningitis?
A: 14 days. Add vancomycin and rifampicin if the micro-organism is highly penicillin- and cephalosporin-resistant.
Q: How is meningitis caused by Haemophilus influenzae treated, and what’s the suggested duration of treatment?
A: Cefotaxime (or ceftriaxone). The suggested duration of antibacterial treatment is 10 days.
Q: When should rifampicin be given for H. influenzae type b meningitis, and to whom?
A: Give rifampicin for 4 days before hospital discharge to those under 10 years of age or to those in contact with vulnerable household contacts.
Q: How is meningitis caused by Listeria treated, and what’s the suggested duration of treatment?
A: Amoxicillin (or ampicillin) + gentamicin. The suggested duration of treatment is 21 days, but consider stopping gentamicin after 7 days. Use co-trimoxazole if there’s a history of immediate hypersensitivity reaction to penicillin.
Regenerate
