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1
NICE. Bacterial meningitis and meningococcal septicaemia. National Collaborating Centre
for Women’s and Children’s health
2009. http://guidance.nice.org.uk/CG102/Guidance
Accessed 23.09.14.

2
Saeed, K., 2011. ‘One for all’ concerns regarding NICE antibiotic guidelines on suspected
bacterial meningitis! [letter] Brit J Gen Pract 2011;61:606. RATIONALE: Expert opinion is
that in children or young people with suspected bacterial meningitis or meningococcal
septicaemia, transfer to hospital is the priority, and that intravenous benzylpenicillin should
be given at the earliest opportunity if a non-blanching rash is present, either in primary or
secondary care. The NICE guideline development group recommended benzylpenicillin
because they are aiming to cover only meningococcal septicaemia, which causes highest
mortality, and it is the most frequently used antibiotic in primary care and they found no
evidence to recommend an alternative antibiotic. Following prompt admission evaluation a
more definitive choice of antimicrobials can be made. Although the scope of the NICE
guideline is for children, it seems reasonable to extrapolate the advice to older age groups.

3
SIGN. Management of invasive meningococcal disease in children and young people.
Scottish Intercollegiate Guidelines Network. 2008
http://www.sign.ac.uk/guidelines/fulltext/102/index.html Accessed 23.09.14. RATIONALE:
Expert opinion is that parenteral antibiotics (either benzylpenicillin or cefotaxime) should be
administered in children as soon as invasive meningococcal disease is suspected, and not
delayed pending investigations/

The POCAST project is funded by the National Institute for Health Research Health Protection Research Unit (NIHR HPRU) in Healthcare Associated Infections and Antimicrobial Resistance at Imperial College London and by the Imperial College Healthcare Charity (Grant Ref No:7006/P36U).