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Table 194-3

Antimicrobial Therapy of Central Nervous System Bacterial Infections Based on Pathogena

ORGANISMANTIBIOTIC
Neisseria meningitides
 Penicillin-sensitivePenicillin G or ampicillin
 Penicillin-resistantCeftriaxone or cefotaxime
Streptococcus pneumoniae
 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 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

a Doses are as indicated in Table 194-2 Antibiotics Used in Empirical Therapy of Bacterial Meningitis and Focal Central Nervous System Infectionsa .