Vancomycin may not be necessary

doi:10.1136/bmj.c4704

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Katherine L Henderson, scientist (epidemiology)1,
Berit Muller-Pebody, scientist (epidemiology)1,
Shamez Ladhani, paediatric infectious diseases consultant12,
Mike Sharland, paediatric infectious diseases consultant2,
Alan P Johnson, consultant clinical scientist1

¹Centre for Infections, Health Protection Agency, London NW9 5EQ
²Paediatric Infectious Disease Unit, St George’s Hospital, London SW17 0QT

Katherine.Henderson{at}hpa.org.uk

The guidelines from the National Institute for Health and Clinical Excellence (NICE) on the empirical treatment of bacterial meningitis in children recommend intravenous ceftriaxone for children aged ≥3 months and cefotaxime plus ampicillin or amoxicillin for infants aged ≥3 months.1 2 The British National Formulary for Children (BNF-C) recommends similar empirical treatment with cefotaxime or cefotaxime and ampicillin, respectively.3 Whereas the BNF-C …