社區性細菌腦膜炎藥物治療建議

病人狀態

建議抗生素

4周以下

Ampicillin + Cefotaxime Ampicillin + Aminoglycoside

4~50

A 3rd generation cephalosporin + Vancomycin

50歲以上

同上外加Ampicillin

基底顱骨骨折

A 3rd generation cephalosporin + Vancomycin

頭部外傷或手術

Vancomycin + Ceftazidime or Cefepime

CSF shunt

Vancomycin + Ceftazidime or Cefepime

 

CSF鑑別腦膜炎致病原

Virus meningities: lymphocyte↑sugar normal

TB meningitis: lymphocyte↑sugar↓

Bacterial meningitis: neutrophil↑sugar↓

 

Meningitis_and_Antiboitics.PNG


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