4. Central nervous system

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

Take cultures

Organism	IV treatment
Bacterial meningitis	Ceftriaxone 2g 12 hourly
Viral encephalitis	Aciclovir 10mg/kg every 8 hours (Reduce dose in renal impairment - seek advice from pharmacy or microbiology)

N.B. In immunocompromised patients or neo-natal meningitis, add IV amoxicillin to cover listeria or group B streptococci. Consult microbiology if penicillin allergy.

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 note the change in policy from previous recommendations

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.