TABLE 25-1. INTRACRANIAL BACTERIAL INFECTIONS OF THE CNS

CONDITION (ORGANISM)

THERAPY

Neonatal meningitis

 

Group B beta-hemolytic streptococci

Penicillin

Enteric bacilli (Escherichia coli, Proteus, Klebsiella)

3rd generation cephalosporin

Listeria  (also in elderly)

Ampicillin or penicillin

Unknown

Gentamicin plus ampicillin or penicillin

Meningitis in children and adults

 

H. influenzae

Penicillin

Meningococcal

Ampicillin or chloramphenicol

Streptococcus pneumonia

Penicillin (chloramphenicol, erythromycin)

Unknown

Ampicillin + cefataxime = cefataxime

Meningitis under unusual circumstances

 

Staphylococcal (penicillinase-positive)

Cloxacillen (Nafcillen, vancomycin)

Gram-negative meningitis

Gentamicin and chloramphenicol

Pseudomonas

Tobramycin, ticarecillin

Tuberculous meningitis

INH and streptomycin plus PAS or ethambutol or rifampin

Neurosyphilis

Penicillin (erythromycin, tetracycline)

Brain abscess (organism unknown)

 

Staphylococci not suspected

Penicillin and either tetracycline or chloramphenicol

Staphylococci suspected

Cloxacillin and chloramphenicol

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