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Table 1. Recommended Antimicrobial Therapy in Patients
with Healthcare-Associated Ventriculitis and
Meningitis Based on Isolated Pathogen and In Vitro
Susceptibility Testing
Microorganism Standard Therapy Alternative Therapies
Staphylococci
a
Methicillin sensitive
Methicillin resistant
Nafcillin or oxacillin
Vancomycin
Vancomycin
Daptomycin,
trimethoprim-
sulfamethoxazole, or
linezolid
Propionibacterium acnes Penicillin G ird-generation
cephalosporin,
b
vancomycin,
daptomycin, or linezolid
Streptococcus pneumoniae
Penicillin MIC ≤0.06 μg/mL
Penicillin MIC ≥0.12 μg/mL
Cefotaxime or ceriaxone
MIC <1.0 μg/mL
Cefotaxime or ceriaxone
MIC ≥1.0 μg/mL
Penicillin G
ird-generation
cephalosporin
b
Vancomycin plus a third-
generation cephalosporin
b,c
ird-generation
cephalosporin
b
Cefepime or meropenem
Moxifloxacin
d
Pseudomonas aeruginosa Cefepime, ceazidime, or
meropenem
Aztreonam or
ciprofloxacin
Haemophilus influenzae
β-lactamase negative
β-lactamase positive
Ampicillin
ird-generation
cephalosporin
b
ird-generation
cephalosporin,
b
cefepime, or a
fluoroquinolone
Cefepime, aztreonam, or
a fluoroquinolone
Extended spectrum
β-lactamase-producing
gram-negative bacilli
Meropenem Cefepime or a
fluoroquinolone
Acinetobacter baumannii Meropenem Colistin (usually
formulated as
colistimethate sodium)
e
or polymyxin B
e
Other Enterobacteriaceae
f
ird-generation
cephalosporin
b
Meropenem, aztreonam,
trimethoprim-
sulfamethoxazole, or
ciprofloxacin
