Specific Therapy for Bacterial Meningitis in Infants Over 3 Months of Age Once Identification and Susceptibility Results Are Known

Streptococcus pneumoniae

Penicillin MIC ≤ 0.06 mcg/mL and ceftriaxone or cefotaxime MIC ≤ 0.5 mcg/mL: Penicillin G or ampicillin for 10–14 days; Penicillin MIC ≤ 0.06 mcg/mL and ceftriaxone or cefotaxime MIC ≤ 0.5 mcg/mL: Penicillin G or ampicillin for 10–14 days;ceftriaxone or cefotaxime also acceptable

Penicillin MIC ≥ 0.12 mcg/mL and ceftriaxone or cefotaxime MIC ≤ 0.5 mcg/mL: Penicillin MIC ≥ 0.12 mcg/mL and ceftriaxone or cefotaxime MIC ≤ 0.5 mcg/mL:Ceftriaxone or cefotaxime for 10–14 days

Penicillin MIC ≥ 0.12 mcg/mL and ceftriaxone or cefotaxime MIC ≥ 1.0 mcg/mL: Penicillin MIC ≥ 0.12 mcg/mL and ceftriaxone or cefotaxime MIC ≥ 1.0 mcg/mL:Ceftriaxone or cefotaxime, plus vancomycin with or without rifampin for 10–14 days vancomycin with or without rifampin for 10–14 days

Neisseria meningitidis

Penicillin G or ampicillin for 7 days (must be followed by rifampin to eliminate carrier state)Penicillin G or ampicillin for 7 days (must be followed by rifampin to eliminate carrier state)

Alternatives: Ceftriaxone or cefotaximeCeftriaxone or cefotaxime

Haemophilus influenzae type b

Ceftriaxone or cefotaxime for 10 daysCeftriaxone or cefotaxime for 10 days

Alternative: Ampicillin if isolate is susceptible (must be followed by rifampin to eliminate carrier state)Ampicillin if isolate is susceptible (must be followed by rifampin to eliminate carrier state)