Which empirical regimen is appropriate for suspected community-acquired bacterial meningitis in an adult?
Answer and explanation
Correct answer: B. Ceftriaxone plus vancomycin, with dexamethasone started before or with the first antibiotic dose
- Step 1: Meningitis is treated before the pathogen is known because delay increases mortality and sequelae. Step 2. A third-generation cephalosporin plus vancomycin covers pneumococcus, including resistant strains; dexamethasone reduces neurological sequelae. Answer: ceftriaxone plus vancomycin with dexamethasone. Why not the others: Oral antibiotics do not reach adequate CSF levels; gentamicin penetrates poorly; antifungals are for a fungal cause.
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