Therapy of suspected bacterial meningitis in Canadian children six weeks of age and older

The present statement reviews recent developments in the epidemiology and makes recommendations for the treatment of suspected bacterial meningitis in Canadian children six weeks of age and older and replaces the 2001 Canadian Paediatric Society statement on this subject (1). Earlier recommendations for mono antibiotic therapy for empirical treatment of suspected bacterial meningitis in children have changed (2,3). The current recommended empirical treatment of bacterial meningitis in infants six weeks of age and older are for a combination of vancomycin and a third-generation cephalosporin. This combination of antibiotics is effective against the three major pathogens that cause meningitis in this age group: Haemophilus influenzae type b (Hib), Streptococcus pneumoniae and Neisseria meningitidis. However, the epidemiology of bacterial meningitis in Canada and the United States continues to change. Thus paediatricians should report cases of bacterial meningitis to public health authorities to assist in ongoing surveillance and the management of contacts within the community. The levels of evidence used in this statement are taken from the Canadian Task Force on Preventive Health.