How is pediatric pneumococcal meningitis treated?

Updated: Jan 14, 2019
  • Author: Meera Varman, MD; Chief Editor: Russell W Steele, MD  more...
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Ceftriaxone or cefotaxime are the drugs of choice because they have the best CSF penetration.

For meningitis, always add vancomycin until susceptibilities are known.

After 24-48 hours of therapy, adding rifampin to vancomycin therapy may be considered if (1) clinical worsening is noted, (2) the follow-up CSF does not show eradication of organism or decrease in bacterial load, or (3) minimum inhibitory concentration (MIC) of pneumococci to cefotaxime is 4 or higher.

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