Table 1:

Recommended empirical antibiotics for suspected bacterial meningitis^*

Vancomycin 60 mg/kg/day given intravenously divided every 6 h (aiming for a peak serum vancomycin level of 30 to 40 mg/L and a trough level of 5 to 10 mg/L) plus either

cefotaxime 300 mg/kg/day given intravenously divided every 6 h

or

ceftriaxone 100 mg/kg intravenously at diagnosis; repeat the dose of 100 mg/kg at 12 h and 24 h, and then 100 mg/kg every 24 h

^*For patients who cannot be given either vancomycin or a third-generation cephalosporin due to a contraindication (eg, allergies), expert infectious diseases opinion should be sought. In all patients, treatment should continue until susceptibility results return. If early cultures indicate a Gram-negative organism, vancomycin may be dropped and an aminoglycoside added