Quick Notes
بعد ما شخصت الحالة، ذلحين الـ treatment. Treatment of pediatric bacterial meningitis: أول شيء المريض ضروري ICU admission. ضروري نعالجه في العناية. أيش عتكتب له؟ يعني الـ advice بعد ما فتحت له ملف. Rx: 1-Paracetamol Dose: 15mg/Kg QID -اللي يعادل 1.5ml/kg…
ليش ما يصلح نعطي Hydrocortisone؟
لأنه يفعل aldosterone like action وعيسوي water retention ويدخل المريض في Cerebral edema.
لأنه يفعل aldosterone like action وعيسوي water retention ويدخل المريض في Cerebral edema.
Note:
-In adults, the primary empiric therapy is 2g IV of either ceftriaxone or cefotaxime (due to concern for Neisseria meningitidis), with 15-20 mg/kg IV vancomycin (to cover for resistant Streptococcus pneumoniae).
-If the patient is immunocompromised or >50 years old, then 2g of IV ampicillin is added due to concern for Listeria monocytogenes.
-In adults, the primary empiric therapy is 2g IV of either ceftriaxone or cefotaxime (due to concern for Neisseria meningitidis), with 15-20 mg/kg IV vancomycin (to cover for resistant Streptococcus pneumoniae).
-If the patient is immunocompromised or >50 years old, then 2g of IV ampicillin is added due to concern for Listeria monocytogenes.
Note:
-Treatment of neonatal meningitis should cover both Group B Streptococcus, Listeria spp., and E. coli.
-Often this is performed with 100mgkg Q8H IV ampicillin, with gentamicin 4mg/kg Q24H IV.
-For young infants (28-90 days), cefotaxime 100mg/kg IV can be an alternative to gentamycin .
-Treatment of neonatal meningitis should cover both Group B Streptococcus, Listeria spp., and E. coli.
-Often this is performed with 100mgkg Q8H IV ampicillin, with gentamicin 4mg/kg Q24H IV.
-For young infants (28-90 days), cefotaxime 100mg/kg IV can be an alternative to gentamycin .
Note:
-For older infants, the recommended treatment is vancomycin 15mg/kg Q6H, with either ceftriaxone 100mg/kg Q12H or cefotaxime 100mg/kg Q8H.
As I explained above.
-For older infants, the recommended treatment is vancomycin 15mg/kg Q6H, with either ceftriaxone 100mg/kg Q12H or cefotaxime 100mg/kg Q8H.
As I explained above.
Note:
-Due to concern for HSV encephalitis 20mg/kg IV acyclovir is also usually added if at all suspected.
-In neonates, if there is suspicion for HSV infection in the mother this should also be added.
Sometimes it's given empirically.
-Due to concern for HSV encephalitis 20mg/kg IV acyclovir is also usually added if at all suspected.
-In neonates, if there is suspicion for HSV infection in the mother this should also be added.
Sometimes it's given empirically.
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"To be a physician is to be ready to sacrifice many things in life, the sleep to serve others, in emergency room, in ICU, in Trauma center, in wards, while others sleep, you may be in shift all the night.In the care of suffering he needs technical skill, scientific knowledge and human understanding. He who uses these with courage, humility and wisdom will provide a unique service to his fellow man and will build an enduring edifice of character within himself. The physician should ask of his destiny no more than this and he should be content with no less".
-Sir Tinsley Harrison