Inpatient Pathway for Treatment of the Febrile Young Infant

CSF Culture POSITIVE

CONSULT INFECTIOUS DISEASES IMMEDIATELY

CSF Culture POSITIVE
arrow
arrow
Gram Positive Organisms
Gram Negative Organisms
arrow
arrow
Vancomycin AND Cefotaxime Continue Ampicillin if < 29 Days
Imipenem AND Amikacin
Continue Gram positive coverage with: Ampicillin or Vancomycin
arrow
arrow
Final Identification & Susceptibilities
arrow
Tailor antibiotics
Determine duration of therapy
Consider PICC Placement
Assess need for repeat LP
arrow
Schedule BAERS
Duration of Therapy for Uncomplicated Meningitis
7 Days Neisseria meningitidis
14 Days

Group β streptococcus
Listeria monocytogenes
Streptoccus pneumoniae

21 Days

E. coli
Other Gram-negative bacilli

For other organisms contact Infectious Diseases

Repeat Lumbar Puncture
  1. Gram negative meningitis
    (excluding Neisseria meningitidis)
  2. Patient is not improving clinically after 48 hours of appropriate antimicrobial therapy
  3. Streptococcus pneumonia meningitis
    1. Organism is penicillin-nonsusceptible by oxacillin disk or quantitative (MIC) testing, results from cefotaxime and ceftriaxone quantitative susceptibility testing are not yet available, AND
    2. Patient's condition has not improved or has worsened; OR
    3. Patient received dexamethasone