🧠 Acute Bacterial Meningitis Empiric Treatment
This tool gives empiric antibiotic and dexamethasone direction for acute bacterial meningitis by clinical scenario, emphasizing early dosing.
Acute Bacterial Meningitis Empiric Treatment
Clinical scenario
When to use
Use to choose the empiric regimen by host scenario and to time dexamethasone, ensuring antibiotics are not delayed for imaging or lumbar puncture.
How it works
General adult → vancomycin + 3rd-gen cephalosporin. Listeria risk (> 50 yr/immunocompromised/pregnant/alcohol) → add ampicillin. Nosocomial/post-neurosurgery → vancomycin + anti-pseudomonal β-lactam. Dexamethasone before/with antibiotics for suspected pneumococcus.
Key points
- Blood cultures are drawn first, but antibiotics and dexamethasone proceed without waiting for CT or lumbar puncture. (original synthesis · not guideline verbatim)
- Listeria coverage with ampicillin is added for older, immunocompromised, pregnant, or alcohol-using patients.
- Therapy is de-escalated by susceptibility once the pathogen is identified.
References
Decision support for licensed clinicians only; not a substitute for clinical judgement, diagnosis or local protocols.