What are the recommended antibiotic regimens for treating bacterial meningitis in different age groups?

For suspected bacterial meningitis, the recommended antibiotic regimens vary by age group:

• Children aged 1-11 months: 300 mg of benzylpenicillin (intravenously or intramuscularly) or a single dose of ceftriaxone at 80 mg/kg (intramuscularly), with a maximum dose of 2000 mg ¹.
• Children aged 1-9 years: 600 mg of benzylpenicillin or a single dose of ceftriaxone at 80 mg/kg (intramuscularly), maximum 2000 mg ¹.
• Children aged 10 years or over and adults: 1200 mg of benzylpenicillin or a single dose of ceftriaxone at 2000 mg ¹.

In hospital, ceftriaxone is preferred for suspected or confirmed bacterial meningitis, with doses based on age and weight, and alternative options include cefotaxime if ceftriaxone is contraindicated ¹,².

For specific causative organisms, such as Neisseria meningitidis, give ceftriaxone (highest doses recommended by the BNF or local guidance), and treatment duration varies from 5 days for meningococcal disease to 10-14 days for other organisms ³.

In cases of antibiotic allergy, advice from an infection specialist is recommended, and alternatives like chloramphenicol or co-trimoxazole may be considered depending on severity and organism ¹,³.