Pediatric patient meningitis

Prior to the introduction of the Hib conjugate vaccine, H. influenzae type b was the most common cause of bacterial meningitis in the United States.5 Routine inoculation of pediatric patients against Hib since 1991 has reduced the incidence of invasive Hib disease (i.e., meningitis and sepsis) in children younger than 5 years of age by 99%,6 with mortality from Hib... 

Bacterial meningitis (pediatric patients 3 months of age or older only) Bacterial meningitis caused by Streptococcus pneumoniae, Haemophilus influenzae ( -lactamase and non- -lactamase-producing strains), and Neisseria meningitidis. 

Use in pediatric patients For pediatric patients 3 months of age and older, the meropenem dose is 20 or 40 mg/kg every 8 hours (maximum dose, 2 g every 8 hours), depending on the type of infection (intra-abdominal or meningitis). Administer pediatric patients weighing more than 50 kg 1 g every 8 hours for intra-abdominal infections and 2 g every 8 hours for meningitis. Give over approximately 15 to 30 minutes or as an IV bolus injection (5 to 20 ml) over approximately 3 to 5 minutes. 

Routine use of dexamethasone in meningitis is not without controversy. A potential concern is that adjunctive dexamethasone therapy might reduce the penetration of antibiotics into the CSF by inhibiting meningeal inflammation. In experimental models of meningitis, steroids decreased the CSF concentrations of ampiciUin, rifampin, vancomycin, and gentamicin. Ceftriaxone penetration into CSF was unaffected by concurrent dexamethasone administration in pediatric patients. ... 

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