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CNS 1.01 Meningitis - Unknown pathogen

Content version
U-141.2
Updated
10/20/2025 - 14:22

Recommendations

≥ 18 years

Indications: No drain, no neurosurgery, no trauma
Dosage Remarks
ceftriaxone IV 2000 mg twice daily

+

amoxicillin IV 2000 mg six times daily

Note: start dexamethasone IV 10 mg four times daily for 4 days
≥ 18 years

Indications: After neurosurgery
Dosage Remarks
flucloxacillin IV 12 g/24 h continuous infusion over 24 hours

+

ceftazidime IV 2000 mg three times daily

Loading dose 2 grams flucloxacillin bolus, then continuous infusion.

If continuous infusion of flucloxacillin is not possible: flucloxacillin 2 g six times daily.
≥ 18 years

Indications: Basilar skull fracture, closed
Dosage Remarks
ceftriaxone IV 2000 mg twice daily
≥ 18 years

Indications: Open basilar skull fracture
Dosage Remarks
flucloxacillin IV 12 g continuous per 24 hours

+

ceftazidime IV 2000 mg three times daily

Loading dose 2 grams flucloxacillin bolus, then continuous infusion.

If continuous infusion of flucloxacillin is not possible: flucloxacillin 2 g six times daily.
≥ 18 years

Indications: in the presence of an internal or external drain
Dosage Remarks

Comments

If cultures are negative (without antibiotics) after 48 hours for community-acquired infections: amoxicillin monotherapy 6 times daily 2000 mg for 14 days

If cultures are negative (without antibiotics) after 72 hours for postoperative and drain-related infections: stop antibiotics