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Management in secondary care

The prevalence, causative pathogens, clinical presentation and outcome of bacterial meningitis in children and young people vary with age (see section 2.1 and chapter 3), and these differences will dictate recommendations for empiric and specific antibiotics. As noted in section 2.1, in older children the most frequent bacteria causing meningitis include N. meningitidis, S. pneumoniae and Hib, whereas in neonates the most common causative organisms are Group B streptococcus, E. coli and L. monocytogenes. The age at which the transition in pathogens occurs is mainly relevant when considering empiric antibiotic choice and is, therefore, conservatively regarded to be 3 months.

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