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Table 2 Empiric antibiotic therapy in acute bacterial meningitis (according to [3, 4])

From: SOP: emergency workup in patients with suspected acute bacterial meningitis

Clinical Situation Empiric antibiotic therapy Dosage
Community-acquired ceftriaxone
plus ampicillina
(plus vancomycinb)
2x2g/day i.v.
6x2g/day i.v.
2x1g/day i.v. (check serum concentration)
Nosocomial Meropenem
plus vancomycin
alternative option:
ceftazidime
plus vancomycin
3x2g/day i.v.
2x1g/day i.v. (check serum concentration)
3x2g/day i.v.
2x1g/day i.v. (check serum concentration)
Immunocompromised patients ceftriaxone
plus ampicillin
plus vancomycinb
2x2g/day i.v.
6x2g/day i.v.
2x1g/day i.v. (check serum concentration)
  1. aIn case of penicillin allergy, the use of meropenem is recommended instead (3x2g/day i.v)
  2. bIn case of a high prevalence of S. pneumoniae that are resistant to 3rd generation cephalosporines (see recommendations of local authorities). As an alternative to vancomycin, rifampicin (1x600mg/day i.v.) can be administered