How should I approach the initial management of a child presenting with suspected bacterial meningitis?

Arrange emergency medical transfer to hospital by telephoning 999 without delay ¹.

Do not delay transfer to hospital to give antibiotics to children with suspected or strongly suspected bacterial meningitis ¹.

If there is likely to be a clinically significant delay in transfer, give intravenous or intramuscular ceftriaxone or benzylpenicillin outside of hospital ¹.

In children with suspected bacterial meningitis, give a single dose of parenteral benzylpenicillin (intravenously or intramuscularly) according to age: 300 mg for 1-11 months, 600 mg for 1-9 years, and 1200 mg for 10 years or over ¹.

Alternatively, administer a single dose of ceftriaxone intravenously or intramuscularly, with doses based on age and weight: children aged 1 month–11 years (up to 50 kg) receive 80 mg/kg (max 2000 mg), children 9–11 years (≥50 kg) and adults/children 12 years or over receive 2000 mg ¹.

Do not give antibiotics if the child has a severe allergy to ceftriaxone or benzylpenicillin ¹.