Basilar skull fracture-associated meningitis
- Recommend pneumococcal vaccination with 13-valent pneumococcal conjugate vaccine followed 8 weeks later with 23-valent pneumococcal polysaccharide vaccine.
- Long term antibiotic prophylaxis is NOT recommended as does not decrease meningitis, mortality, or need for surgical correction.
Usual Pathogens
S. pneumoniae
H. influenzae
Group A Streptococci
N. meningitidis
If prolonged hospitalization:
S. aureus/MRSA
Enterobacterales
| Empiric Therapy | Dose | Duration |
|---|---|---|
| Ceftriaxone | 2g IV q12h | ≥ 10 days |
| + | ||
| Vancomycin | 15mg/kg IV q8-12h |
Ceftriaxone allergy
| Empiric Therapy | Dose | Duration |
|---|---|---|
| Moxifloxacin | 400mg IV daily | ≥ 10 days |
| + | ||
| Vancomycin | 15mg/kg IV q8-12h |