'One for all' concerns regarding NICE antibiotic guidelines on suspected bacterial meningitis!

摘要

The most common bacteria causing meningitis include Streptococcus pneumoniae, Neisseria meningitides, and Haemophillus influenzae. Guidelines issued by the National Institute for Health and Clinical Excellence (NICE) in regards to bacterial meningitis recommend administration of benzylpenicillin for children and young patients with suspected meningococcal disease in the pre-hospital setting. This is in accordance with existing advice issued by the chief medical officer.1'2 However, when the same patient comes in to hospital, the advice on the empirical antibiotic choice changes to third generation cephalosporins (with or without high dose amoxicillin depending on risk factors for Listeria monocytogenes infections) this means that, essentially, the same patient can be prescribed different antibiotics depending on where he or she is first seen!