The National Institute for Health and Clinical Excellence (NICE) in association with the Royal College of Paediatrics and Child Health and the Royal College of Obstetricians and Gynaecologists have published clinical guidelines on the management of bacterial meningitis and meningococcal septicaemia in children and young people younger than 16 years in primary and secondary care.

With respect to pre-hospital management of suspected meningococcal disease (meningitis with non-blanching rash or meningococcal septicaemia the following recommendations have been made:

• Give parenteral antibiotics (intramuscular or intravenous benzylpenicillin) at the earliest opportunity, either in primary or secondary care, but do not delay urgent transfer to hospital to give the parenteral antibiotics.

• Withhold benzylpenicillin only in children and young people who have a clear history of anaphylaxis after a previous dose; a history of a rash following penicillin is not a contra-indication.

The guideline also covers the following aspects of management of patients in secondary care:

• Antibiotics for suspected bacterial meningitis or meningococcal disease

• Treatment for specific infections in confirmed bacterial meningitis

• Fluid management in suspected or confirmed bacterial meningitis

• Intravenous fluid resuscitation in meningococcal septicaemia

• Type and volume of intravenous fluids for meningococcal septicaemia

• Respiratory support in children and young people with suspected or confirmed bacterial meningitis or meningococcal septicaemia

• Corticosteroids for bacterial meningitis

• Corticosteroids for meningococcal septicaemia

• Adjunctive therapies

• Monitoring for deterioration for meningococcal disease Introduction

Please see link below for details.