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ANTIBIOTIC DRAGS :
Management of children with suspected meningitis PAWC (MCWH: Provincial Reference Group)• Ceftriaxone 100mg/kg stat dose intravenous or intramuscular- drug of choice
(ceftriaxone is on the EDL and should be available at all clinics).
• If ceftriaxone not available:
Penicillin G 100 000u/kg stat dose intravenous or intramuscular plusChloramphenicol 25mg/kg stat dose intravenous or intramuscular (or even orally).
(Use half the dose of penicillin and chloramphenicol in infants younger than 2 weeks.)
TREATMENT OF CONVULSIONS
• Diazepam rectally - 5mg if less than 1 year of age or 10 mg if older than a year.
• Repeat after 10 minutes if still convulsing.
• If convulsions continue give phenobarbitone 15 - 20mg/kg stat dose intravenous or
intramuscular (max initial dose 200mg).
• Check blood glucose (see below) and blood pressure.
• Control fever with paracetamol (orally or by nasogastric tube) and tepid sponging
MANAGEMENT OF SHOCK
• Stabilize patient before referral – give fluids and oxygen.
• Put up a drip (or an intraosseus line) and give repeated boluses of Saline or Ringers
Lactate (10ml/kg at a time - maximum of 40ml/kg), until pulses are felt more easily.
• This is especially important in meningococcal disease.
GENERAL SUPPORTIVE CARE
• If vomiting or unable to feed, give maintenance fluids containing 10% dextrose.
• Do heel prick or finger prick blood glucose estimation to check for hypoglycaemia - If
blood glucose < 2.6 mmol/l give 10% dextrose solution: 2-4 mls/kg intravenous bolus or
10ml/kg via a nasogastric tube. Repeat the test after 15 minutes. Continue with
maintenance fluid 75ml/kg/day
PROPHYLAXIS
• Household and close contacts (class at school or creche) of patients with meningococcaldisease must be given prophylaxis to prevent secondary cases.
• Give rifampicin: < 1 month 5 mg/kg 12 hourly for 2 days
1 month to 12 years 10mg/kg 12 hourly for 2 days
adults 600mg 12 hourly for 2 days
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