Predisposing factor | Common bacterial pathogens | Antimicrobial therapy |
Age | ||
<1 month | Streptococcus agalactiae, Escherichia coli, Listeria monocytogenes | Ampicillin plus cefotaxime; OR ampicillin plus an aminoglycoside |
1 to 23 months | Streptococcus pneumoniae, Neisseria meningitidis, S. agalactiae, Haemophilus influenzae, E. coli | Vancomycin plus a third-generation cephalosporin¶Δ◊ |
2 to 50 years | N. meningitidis, S. pneumoniae | Vancomycin plus a third-generation cephalosporin¶Δ◊ |
>50 years | S. pneumoniae, N. meningitidis, L. monocytogenes, aerobic gram-negative bacilli | Vancomycin plus ampicillin plus a third-generation cephalosporin¶Δ |
Head trauma | ||
Basilar skull fracture | S. pneumoniae, H. influenzae, group A beta-hemolytic streptococci | Vancomycin plus a third-generation cephalosporin¶Δ |
Penetrating trauma | Staphylococcus aureus, coagulase-negative staphylococci (especially Staphylococcus epidermidis), aerobic gram-negative bacilli (including Pseudomonas aeruginosa) | Vancomycin plus cefepime; OR vancomycin plus ceftazidime; OR vancomycin plus meropenem |
Postneurosurgery | Aerobic gram-negative bacilli (including P. aeruginosa), S. aureus, coagulase-negative staphylococci (especially S. epidermidis) | Vancomycin plus cefepime; OR vancomycin plus ceftazidime; OR vancomycin plus meropenem |
Immunocompromised state | S. pneumoniae, N. meningitidis, L. monocytogenes, aerobic gram-negative bacilli (including P. aeruginosa) | Vancomycin plus ampicillin plus cefepime; OR vancomycin plus meropenem§ |
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