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Table 191-3

Antimicrobial Therapy of Central Nervous System Bacterial Infections Based on Pathogena

OrganismAntibiotic
Neisseria meningitides
Penicillin-sensitivePenicillin G or ampicillin
Penicillin-resistantCeftriaxone or cefotaxime
Streptococcus pneumonia
Penicillin-sensitivePenicillin G
Penicillin-intermediateCeftriaxone or cefotaxime or cefepime
Penicillin-resistantCeftriaxone (or cefotaxime or cefepime) + vancomycin
Gram-negative bacilli (except Pseudomonas spp.)Ceftriaxone or cefotaxime
Pseudomonas aeruginosaCeftazidime or cefepime or meropenem
Staphylococci spp.
Methicillin-sensitiveNafcillin
Methicillin-resistantVancomycin
Listeria monocytogenesAmpicillin + gentamicin
Haemophilus influenzaeCeftriaxone or cefotaxime or cefepime
Streptococcus agalactiaePenicillin G or ampicillin
Bacteroides fragilisMetronidazole
Fusobacterium spp.Metronidazole

aDoses are as indicated in Table 191-2.