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What are the most likely pathogens for meningitis in newborns?
E. coli
Klebsiella spp
S. agalactiae
Enterobacter spp
What are the most likely pathogens for meningitis in 1mo - 29yo?
N. meningitidis
S. pneumoniae
H. influenzae
What are the most likely pathogens for meningitis in 30-72yo?
S. pneumoniae
N. mengitidis
What causes problems with drug concentrations in the CSF?
age dependent volume
constantly produced
constant flow
What considerations should be applied to selection of antibiotic therapy for meningitis?
Low protein binding
lipid soluble
small molecular weight
unionized at physiologic pH
Absence or presence of meningeal inflammation
Which antibiotics do not rely on inflammation of the meninges to treat meningitis?
Bactrim
Chloramphenicol
Isoniazid
Rifampin
Linezolid
Which antibiotics rely on inflammation of the meninges to treat meningitis?
Ampicillin
Aztreonam
Cefotaxime
Ceftazidime
Cedftriaxone
Cefuroxime
Ciprofloxacin
Levofloxacin
Imipenem/Meropenem
Pen G
Piperacillin
Ticarcillin
Doxycycline
Vancomycin (and still not very good penetration)
TCNs
Tigecycline
What is the empiric therapy for meningitis in neonates?
Ampicillin + 3rd gen ceph + Vancomycin
What is the empiric therapy for meningitis in 3mo - 50yo?
3rd gen ceph +/- Vancomycin
What is the empiric therapy for meningitis in >50yo?
Ampicillin + 3rd gen ceph +/- Vancomycin
What is the treatment for meningitis caused by S. pneumoniae?
Pen G (DOC)
Ceftriaxone (used more often than Pen G d/t convenience)
Cefuroxime
Chloramphenicol (almost never used)
Vancomycin
What is the treatment for meningitis caused by Pen-resistant S. pneumoniae (PRSP)?
Vancomycin + Rifampin, FQ, or Linezolid
What is the treatment for meningitis caused by H. influenzae?
Ampicillin (DOC if B-Lactamase neg.)
Ceftriaxone (DOC if B-lactamase pos.)
Chloramphenicol
FQ
Bactrim
What is the treatment for meningitis caused by N. meningitidis?
Pen G (DOC)
Ceftriaxone (used more than Pen G d/t convenience)
Chloramphenicol
FQ
What is the treatment for meningitis caused by S. agalactiae?
Pen G (DOC)
Ceftriaxone
Chloramphenicol
Bactrim
What is the treatment for meningitis caused by L. monocytogenes?
Ampicillin (DOC)
Bactrim
Linezolid
What are the risks and benefits of using adjunctive corticosteroid therapy in meningitis?
significantly less hearing loss and other neurologic sequelae in some children receiving Dexamethasone
may decrease antibiotic penetration
When should corticosteroid adjunctive therapy be given for meningitis?
before or at the same time as the first dose of antibiotics (prevents increased inflammation d/t toxin release from cell lysis of first dose of ABX)
What is the prophylaxis for S. pneumoniae meningitis?
Vaccination
NO chemoprophylaxis
What is the prophylaxis for H. influenzae meningitis?
Chemoprophylaxis
:
Rifampin
FQ + Ceftriaxone
Vaccination
What is the prophylaxis for N. meningitidis meningitis?
Chemoprophylaxis
:
Rifampin
FQ + Ceftriaxone
Vaccination
What are the possible causes of aseptic meningitis?
viral meningitis/encephalitis
Mycobacterial meningitis
Fungal meningitis
Helminth diseases
Chemically induced (NSAIDs - Ibuprofen #1, various chemotherapeutics)
What is the treatment for brain abscess?
surgery
Metronidazole
Chloramphenicol
Author
giddyupp
ID
63936
Card Set
CNS Infections
Description
CNS Infections
Updated
2011-02-04T16:47:00Z
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