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.
Check our archive to test your knowledge in other pediatric cases:
If you do not already have Acrobat Reader, simply click on the icon below,
scroll down to the "Get the Free Acrobat Reader" heading and
follow the instructions to install the program. Acrobat enables you to convert
any document into an Adobe Portable Document Format (PDF) file for easy viewing.