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Fever and Seizure Activity in a 10-Month-Old Boy

	Answer 2 Ceftriaxone and vancomycin. Empiric coverage for suspected pneumococcal meningitis should include vancomycin in combination with either ceftriaxone or cefotaxime. Ceftriaxone and cefotaxime are both effective against most of the major pathogens in bacterial meningitis. Vancomycin is added because of the increasing numbers of strains now resistant to penicillin and cephalosporins. Vancomycin should not be used alone because of the difficulty in maintaining bactericidal levels of this drug in the cerebrospinal fluid. Rifampin is not part of routine empiric management. Click here to return to the questions
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