From the Guidelines
The treatment for meningococcal meningitis requires immediate administration of antibiotics, typically starting with a third-generation cephalosporin such as ceftriaxone (2g IV every 12 hours for adults) or cefotaxime (2g IV every 6-hourly) as recommended by the UK Joint Specialist Societies guideline on the diagnosis and management of acute meningitis and meningococcal sepsis in immunocompetent adults 1.
Key Considerations
- The choice of antibiotic should be based on the identification of the causative organism, with ceftriaxone or cefotaxime being the preferred initial treatment options.
- If the patient is not treated with ceftriaxone, a single dose of 500 mg ciprofloxacin orally should also be given 1.
- For patients with confirmed meningococcal meningitis who have recovered by day 5, treatment can be stopped 1.
- Close contacts of the patient should receive prophylactic antibiotics such as ciprofloxacin (500mg as a single dose), rifampin (600mg twice daily for 2 days), or ceftriaxone (250mg IM single dose) to prevent secondary cases 1.
Duration of Treatment
- The duration of antibiotic therapy depends on the pathogen identified, with a recommended treatment duration of 5 days for meningococcal disease if the patient has clinically recovered 1.
Supportive Care
- Supportive care is essential, including fluid management, seizure control if needed, and monitoring for increased intracranial pressure.
- Dexamethasone (0.15 mg/kg IV every 6 hours for 2-4 days) should be started before or with the first antibiotic dose to reduce inflammation and improve outcomes, although its use is not universally recommended and should be considered on a case-by-case basis 1.
From the FDA Drug Label
In the treatment of meningitis, it is recommended that the initial therapeutic dose be 100 mg/kg (not to exceed 4 grams). Thereafter, a total daily dose of 100 mg/kg/day (not to exceed 4 grams daily) is recommended. MENINGITIS Caused by Haemophilus influenzae, Neisseria meningitidis or Streptococcus pneumoniae
The treatment for meningococcal meningitis is Ceftriaxone administered intravenously, with an initial dose of 100 mg/kg (not to exceed 4 grams) and a total daily dose of 100 mg/kg/day (not to exceed 4 grams daily) 2.
- The recommended duration of therapy is 7 to 14 days.
- Ceftriaxone is effective against Neisseria meningitidis, one of the causative organisms of meningococcal meningitis 2.
From the Research
Treatment for Meningococcal Meningitis
The treatment for meningococcal meningitis typically involves the use of antibiotics. The choice of antibiotic may depend on various factors, including the severity of the disease, the patient's age, and the presence of any underlying medical conditions.
- Antibiotic Options:
- Ceftriaxone is a commonly used antibiotic for the treatment of meningococcal meningitis, as it has been shown to be effective against Neisseria meningitidis 3, 4.
- Other antibiotics, such as rifampin, ciprofloxacin, and azithromycin, may also be used as prophylaxis for close contacts of patients with meningococcal disease 5, 3.
- Penicillin G is another option, but its use may be limited due to the potential for resistance 4.
Duration of Treatment
- The duration of treatment for meningococcal meningitis typically ranges from 7 to 10 days in uncomplicated cases 6.
- In more severe cases or in cases where there are complications, the duration of treatment may be longer, up to 14 days or more 7, 6.
Special Considerations
- Ciprofloxacin Resistance: In areas where ciprofloxacin-resistant strains of Neisseria meningitidis are prevalent, alternative antibiotics such as rifampin, ceftriaxone, or azithromycin may be preferred for prophylaxis 5.
- Pediatric Patients: The treatment of meningococcal meningitis in pediatric patients may involve the use of combination therapy, including cefotaxime or ceftriaxone, and vancomycin 7.
- Newborns: The treatment of meningococcal meningitis in newborns may require a longer duration of therapy, typically at least 15 days, and may involve the use of different antibiotics, such as amikacin 6.