9. Central nervous system

In suspected cases of meningitis / meningococcal septicaemia treat IMMEDIATELY. Do not wait for sensitivity results.

Take cultures

Organism

IV treatment

Duration

Bacterial meningitis

Ceftriaxone 2g every 12 hourly

7-10 days

Listeria meningitis - suspected or confirmed

Amoxicillin 2g every 6 hours plus gentamicin 5mg/kg (see protocol)

10-14 days

Viral encephalitis

Aciclovir 10mg/kg every 8 hours*

14-21 days

*For patients with renal impairment refer to section 23 for dosage adjustments

NOTES:
In obese patients dose of aciclovir should be based on lean body weight (See treatment of viral infections section 17)

Consult microbiology if penicillin allergy.
Review on the advice of microbiology.

For close contacts of meningococcal or haemophilus infections, prophylaxis will be arranged by the Department of Public Health Medicine where the patient is resident. It should only be given to hospital staff in exceptional circumstances, e.g. when mouth-to-mouth resuscitation has been performed.

Important
Please ensure cephalosporins are clearly written on the prescription chart and take care that the correct drug is administered as the names and packaging are often very similar.