Chapter 82 Bacterial Meningitis Q&A (1 of 16) Sample Questions

1. Mark is 10-year-old boy suffering from uncomplicated bacterial meningitis. His doctor started an empiric therapy of Ceftriaxone injection but there was no response seen after three days. His doctor is hesitant to order diagnostic culture because it may not be positive as he has been previously treated with antibiotics. What is the appropriate therapy?
  1. A. Ceftriaxone iv+ iv Vancomycin 10 to 14 d +/- Rifampin 4 d
  2. B. High dose Ceftriaxone
  3. C. High dose of Penicillin G
  4. D. High dose Ciprofloxacin
Ans: A
Tips: For Penicillin and Cephalosporin resistant pneumococci, the use of Cephalosporin’s alone even in high doses, may be inadequate. The addition of Vancomycin+/- Rifampin to high dose Cephalosporin appears to enhance bacterial eradication in the CSF.