IDSA Meningitis — Practice Guidelines for the Management of Bacterial Meningitis

Adjunctive dexamethasone (10 mg IV) should be given prior to or with the first antibiotic dose in suspected or proven pneumococcal meningitis. Empiric therapy consists of vancomycin plus a 3rd-generation cephalosporin (plus ampicillin for Listeria in age >50 or immunocompromised).