Corrigendum to “The UK joint specialist societies guideline on the diagnosis and management of acute meningitis and meningococcal sepsis in immunocompetent Adults” [J Infect 72 (2016) 405–438]
Authors: F. McGill, R.S. Heyderman, B.D. Michael, S. Defres, N.J. Beeching, R. Borrow, L. Glennie, O. Gaillemin, D. Wyncoll, E. Kaczmarski, S. Nadel, G. Thwaites, J. Cohen, N.W.S. Davies, A. Miller, A. Rhodes, R. Read, T. Solomon
Journal: Journal of Infection (2016)

The authors regret the following footnote should have been included with Table 6: In cases where Chloramphenicol is used (known anaphylaxis to penicillins or cephalosporins) the dose may be reduced to 12.5 mg/kg 6 hourly if the patient is recovering, to reduce the risk of a dose-related anaemia. Table 6 is reproduced again here with the addition of the footnote. The authors would like to apologise for any inconvenience caused.Table 6Definitive antibiotic treatment.AetiologyAntibiotic (s)DoseAlternative antibiotic choicesDoseDurationbTreatment durations may need to be extended if patient is not responding.Neisseria meningitidisCefotaximeORCeftriaxone2 g 6 hourly/2 g 12 hourlyChloramphenicol (if anaphylaxis) OR Benzylpenicillin25 mg/kg 6 hourly2.4 g 4 hourly5 daysStreptococcus pneumoniae (sensitivities unknown or penicillin resistant, cephalosporin sensitive)CefotaximeaAdd in IV Vancomycin 15–20 mg/kg bd or Rifampicin 600 mg bd if penicillin resistance is suspected e.g. patient has recently arrived from a country where penicillin resistant pneumococci is prevalent (if unsure, check with local infectious diseases/microbiology expertise.ORCeftriaxoneaAdd in IV Vancomycin 15–20 mg/kg bd or Rifampicin 600 mg bd if penicillin resistance is suspected e.g. patient has recently arrived from a country where penicillin resistant pneumococci is prevalent (if unsure, check with local infectious diseases/microbiology expertise.2 g 6 hourly2 g 12 hourlyChloramphenicol25 mg/kg 6 hourly10 days (if stable)Up to 14 days if taking longer to respondStreptococcus pneumoniae (penicillin sensitive, MIC≤0.06)BenzylpenicillinORCefotaximeORCeftriaxonecIf low risk of Clostridium difficile infection and/or requiring outpatient therapy.2.4 g 4 hourly2 g 6 hourly/2 g 12 hourlyChloramphenicol25 mg/kg 6 hourly10 days (if stable)Up to 14 days if taking longer to respondStreptococcus pneumoniae (penicillin and cephalosporin non-susceptible, penicillin MIC>0.06 or cefotaxime/ceftriaxone MIC>0.5)CefotaximeORCeftriaxoneANDVancomycindSerum vancomycin trough concentrations of 15–20 ug/ml should be aimed for.ORRifampicin2 g 6 hourly2 g 12 hourly15–20 mg/kg 12 hourly (adjusting according to serum trough levels)600 mg bdChloramphenicoleIn cases where Chloramphenicol is used (known anaphylaxis to penicillins or cephalosporins) the dose may be reduced to 12.5 mg/kg 6 hourly if the patient is recovering, to reduce the risk of a dose-related anaemia.25 mg/kg 6 hourly14 daysListeria monocytogenesAmoxicillin2 g 4 hourlyCo-trimoxazole10–20 mg/kg (of the trimethoprim component) in 4 divided doses21 daysHaemophilus influenzaeCefotaximeORCeftriaxone2 g 6 hourly2 g 12 hourlyMoxifloxacin400 mg od10 daysa Add in IV Vancomycin 15–20 mg/kg bd or Rifampicin 600 mg bd if penicillin resistance is suspected e.g. patient has recently arrived from a country where penicillin resistant pneumococci is prevalent (if unsure, check with local infectious diseases/microbiology expertise.b Treatment durations may need to be extended if patient is not responding.c If low risk of Clostridium difficile infection and/or requiring outpatient therapy.d Serum vancomycin trough concentrations of 15–20 ug/ml should be aimed for.e In cases where Chloramphenicol is used (known anaphylaxis to penicillins or cephalosporins) the dose may be reduced to 12.5 mg/kg 6 hourly if the patient is recovering, to reduce the risk of a dose-related anaemia. Open table in a new tab The UK joint specialist societies guideline on the diagnosis and management of acute meningitis and meningococcal sepsis in immunocompetent adultsJournal of InfectionVol. 72Issue 4PreviewBacterial meningitis and meningococcal sepsis are rare conditions with high case fatality rates. Early recognition and prompt treatment saves lives. In 1999 the British Infection Society produced a consensus statement for the management of immunocompetent adults with meningitis and meningococcal sepsis. Since 1999 there have been many changes. We therefore set out to produce revised guidelines which provide a standardised evidence-based approach to the management of acute community acquired meningitis and meningococcal sepsis in adults. Full-Text PDF Open Access