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15 mg/kg 12 g 4 6 g 12 g 6g 4g 6g 800 1200 mg 5 mg/kg 1200 mg 3 6 g 9 12 g 9 12 g 24 million units 225 mg/kg 600 mg 5 mg/kg 20 mg/kg 2 3 g

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Unless indicated, therapy is administered intravenously Aminoglycosides are not used as sole treatment for meningitis Peak and trough serum concentrations should be monitored c Higher dose recommended for pneumococcal meningitis d Risk of seizures with meropenem e Oral administration f Dosage based on trimethoprim component g CSF concentrations may have to be monitored in severely ill patients Newer drugs are available for methicillin-resistant staph infections but are not well studied for staphylococcal meningitis: linezolid, quinupristin-dalfopristin, and daptomycin

Bacteria Haemophilus in uenzae B-lactamase-negative B-lactamase-positive Neisseria meningitidis Streptococcus pneumoniae Penicillin MIC 01 g/mL (sensitive) Penicillin MIC 01 10 g/mL (intermediate sensitivity) Penicillin MIC 20 g/mL (highly resistant) Enterobacteriaceae Pseudomonas aeruginosa Listeria monocytogenes Streptococcus agalactiae Staphylococcus aureus Methicillin-sensitive Methicillin-resistantd Staphylococcus epidermidis

A portfolio displays the position of an object (enterprise, product, and so on) in a fourfield matrix The position of the object is defined using two dimensions and the X and Y axes depending on the movement of the overall amounts or values So, the base of zero is moving to correct for some variance that is defined Portfolios are used mainly in enterprise and product comparisons A portfolio can be sorted, for example, like the products of an enterprise by their dimensions economics and strategic significance The most important aspect of this chart type is the construction of the underlying query to support it Once you get this set up correctly, the final build of the chart itself is routine You build the underlying table for a portfolio as follows: The first data column contains the values to be entered on the X axis The second data column contains the values to be entered on the Y axis The third data column is relevant for the bubble size You can add further pairs of data columns to the table The first data column of a pair always contains the Y values and the second data column the bubble size The X value of a data point is always defined from the first data column The Y value of a data point is defined from the second data column, depending on the data column to which the data point belongs The X and Y values together give you the center of the bubble In the following example, the X axis is the Net Sales, Y is the Invoiced Quantity, and the bubble size as the average value Sales/Quantity

Ampicillin Third-generation cephalosporina Penicillin G or ampicillin Penicillin G or ampicillin Third-generation cephalosporina Vancomycin plus third-generation cephalosporin Third-generation cephalosporina Ceftazidime or cefepimeb Ampicillin or penicillin Gb Ampicillin or penicillin Gb Nafcillin or oxacillin Vancomycinc

Third-generation cephalosporina; chloramphenicol Chloramphenicol; cefepime Third-generation cephalosporina; chloramphenicol Third-generation cephalosporina; chloramphenicol; vancomycin plus rifampin Vancomycin; meropenem Meropenem Meropenem; uoroquinolone; trimethoprim/ sulfamethoxazole, or cefepime Meropenem; uoroquinoloneb; pipericillin Trimethoprim/sulfamethoxazole Third-generation cephalosporina; vancomycin Vancomycin Linezolid, quinupristan-dalfopristan, daptomycin Vancomycinc

Key: MIC Minimal inhibitory concentration a Cefotaxime or ceftriaxone b Addition of an aminoglycoside should be considered c Addition of rifampin should be considered d Linezolid, quinupristan-dalfopristan, and daptomycin are newer alternatives for methicillin-resistant Staphylococcus, but few cases have been studied

low for many days after other signs of infection have subsided and should occasion concern only if bacteria are present in the uid and the patient remains febrile and ill Prolongation of fever or the late appearance of drowsiness, hemiparesis, or seizures should raise the suspicion of subdural effusion, mastoiditis, sinus thrombosis, cortical vein or jugular phlebitis, or brain abscess; all require that therapy be continued for a longer period Bacteriologic relapse after treatment is discontinued requires reinstitution of therapy Corticosteroids Early controlled studies demonstrated no bene cial effects of corticosteroids in the treatment of pyogenic meningitis More recent studies have given another perspective of the therapeutic value of dexamethasone in children and adults with meningitis In children, although mortality was not affected in the main study conducted by Lebel and colleagues, fever subsided more rapidly and the incidence of sensorineural deafness and other neurologic sequelae was reduced, particularly in those with H in uenzae meningitis On these grounds, it is recommended that the treatment of childhood meningitis include dexamethasone in high doses (015 mg/kg four times daily for 4 days), instituted as soon as possible Despite con icting results from earlier studies of corticosteroids in adults, the trial by deGans and van de Beck has persuasively demonstrated a reduction in mortality and improved overall outcome if dexamethasone 10 mg is given just before the rst dose of antibiotics and every 6 h for 4 days The improvement was largely in patients who were infected with pneumococcus Seizures and coma were reduced in incidence as a result of the administration of corticosteroids, but neurologic sequlae, such as hearing loss,

Product Group Accessories Bag & Outdoor Office Net Sales 2,158,05118 1,931,71005 1,843,49499 X Values Invoiced Quantity 820,857,004 153,849,431 534,755,366 Y Values Sales/Quantity 263 1256 345