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Flashcards in Meningitis Deck (21):
1

Most common cause of meningitis in the US

streptococcus pneumoniae

2

empiric therapy for a child under 1 month

ampicillin + cefotaxime or gentamicin

3

empiric therapy for ages 1 month-50 years

cefotaxime or ceftriaxone + vancomycin (+dexamethasone)

4

empiric therapy for people over 50 years or alcoholics

ampicillin + ceftriaxone or cefotaxime + vancomycin (+dexamethasone)

5

when do you add ampicillin?

when you suspect Listeria

6

this is an anti-inflammatory drug that needs to be administered before antibiotics, improves CNS parameters, and does not effect penetration of vancomycin

dexamethasone

7

this drug can decrease hearing loss that can occur with administration of vancomycin

dexamethasone

8

do not give this drug to patients with meningitis and septic shock

dexamethasone

9

Expect infection with this gram negative diplococci in children and young adults, in winter and spring. It can cause pts to have behavioral changes, seizures, coma, DIC, purpuric lesions

N. meningitidis

10

Drug of choice for treatment of N. meningitidis meningitis

high dose IV PCN G
(alternatives include cefotaxime, ceftriaxone, and chloramphenicol)

11

prophylaxis regimen for N. meningitidis

Rifampin (adults and children)
Ceftriaxone (pregnancy)

12

Expect infection with this gram positive diplococci commonly in adults and children. Especially in pts with pneumonia, endocarditis, splenectomy, head trauma, alcoholism, sickle cell disease, and bone marrow transplant

S. pneumoniae

13

Treatment of S pneumoniae meningitis

Cefotaxime
Ceftriaxone
in PCN susceptible, switch to PCN
switch to vanco if resistant to beta lactams

14

Expect infection with this gram negative bacilli if a patient shows up with morbiliform or petechial rash (rare)

H. influenzae

15

treatment of h influenzae meningitis

ceftriaxone or cefotaxime

16

Prophylaxis for H influenzae

Rifampin (unless fully vaccinated and over 2 years)

17

Expect infection with this gram positive bacilli in neonates, immunocompromised adults, and the elderly. Common in the summer and early fall

Listeria

18

DOC for treatment of listeria

IV ampicillin (or PCN) plus an aminoglycoside
can use TMP/SMX if allergic

19

Expect infection with this type of bacteria infrequently. Risk factors include cranial trauma, neurosurgery, immunosuppression, hospitalization, and elderly.

gram negative bacilli (e coli, klebsiella, pseudomonas)

20

treatment for pseudomonas

IV ceftazidime plus gentamicin

21

treatment for e coli or klebsiella

3rd generation cephalosporins