What are the recommended antibiotic regimens for treating bacterial meningitis in different age groups?

Guideline-aligned answer with reasoning, red flags and references. Clinically reviewed by Dr Kola Tytler MBBS CertHE MBA MRCGP.

Posted: 16 August 2025Updated: 16 August 2025 Guideline-Aligned (High Confidence) Clinically Reviewed
Dr Kola Tytler MBBS CertHE MBA MRCGPClinical Lead • iatroX

For suspected bacterial meningitis, the recommended antibiotic regimens vary by age group:

  • Children aged 1-11 months: 300 mg of benzylpenicillin (intravenously or intramuscularly) or a single dose of ceftriaxone at 80 mg/kg (intramuscularly), with a maximum dose of 2000 mg .
  • Children aged 1-9 years: 600 mg of benzylpenicillin or a single dose of ceftriaxone at 80 mg/kg (intramuscularly), maximum 2000 mg .
  • Children aged 10 years or over and adults: 1200 mg of benzylpenicillin or a single dose of ceftriaxone at 2000 mg .

In hospital, ceftriaxone is preferred for suspected or confirmed bacterial meningitis, with doses based on age and weight, and alternative options include cefotaxime if ceftriaxone is contraindicated ,.

For specific causative organisms, such as Neisseria meningitidis, give ceftriaxone (highest doses recommended by the BNF or local guidance), and treatment duration varies from 5 days for meningococcal disease to 10-14 days for other organisms .

In cases of antibiotic allergy, advice from an infection specialist is recommended, and alternatives like chloramphenicol or co-trimoxazole may be considered depending on severity and organism ,.

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