Treatment of Streptococcal Meningitis Caused by Penicillin-Resistant, Third-Generation Cephalosporin-Susceptible Streptococcus pneumoniae

This protocol is for patients with confirmed Streptococcus pneumoniae meningitis whose isolate falls outside the reliable range for penicillin yet remains susceptible to third-generation cephalosporins — a specific susceptibility profile that directly determines the choice of therapy.

Management centres on an intravenous third-generation cephalosporin — agents in this class such as ceftriaxone or cefotaxime are the primary options. Adjunctive corticosteroid therapy is an integral part of the regimen and is initiated together with the first antibiotic dose. Alternative agents from other drug classes are available for situations where the primary options cannot be used. The complete regimen — including precise agent selection, duration, and all adjunctive therapy details — is set out in the full structured protocol.