Table 4.

Initial treatment of purulent meningitis with negative direct examination, according to predisposing factors and/or signs of severity [1]

Patient	Suspected organisms	Treatment (posology)
Child	Neisseria meningitidis	Amoxicillin or 3-GC
	Streptococcus pneumoniae	3-GC + vancomycin
	Haemophilus influenzae	40-60 mg/kg per day. Four infusions = 1 h or continuous infusion
		(load: 15 mg/kg) 3-GC
Adult	Streptococcus pneumoniae	Preference 3-GC
	If suspicion of penicillin-resistant pneumococci and/or signs of severity	3-GC + vancomycin 40-60 mg/kg per day. Four infusions = 1 h or continuous infusion (load: 15 mg/kg)
	Listeria monocytogenes	Amoxicillin is indispensable in association with gentamicin or co trimoxazole
	Neisseria meningitidis	Amoxicillin or 3-GC
Child and adult	Absence of predisposing factors and signs of severity	Amoxicillin + 3-GC

3-GC, cefotaxime or ceftriaxone (see Table 1 for posologies).