Antimicrobial therapy for bacterial meningitis

Abstract

Reasonable choices of antimicrobial therapy for treatment of bacterial meningitis in adult horses include ampicillin and chloramphenicol. Potentiated sulphonamides may be appropriate depending on the MIC of the organism involved. Choice of therapeutic agent may initially be based on CSF cytology and Gram stain, but culture and sensitivity data should be obtained. Use of enrofloxacin may be appropriate if antimicrobial isolates show resistance to the aforementioned drugs, but the possibility of induction of, or worsening of seizure activity should be considered. Rifampin may be beneficial when used in combination with other antimicrobial agents. Use of many of these antimicrobials agents is extralabel. Use of third and fourth generation cephalosporins may be appropriate in foals and small ponies or in adult horses with no financial constraints to treatment.