Professional and Linguistic Assessments Board (PLAB) Practice Exam

What is the recommended treatment for meningitis in a college student?

1. IV vancomycin

2. IV ceftriaxone or cefotaxime

3. Intravenous acyclovir

4. Oral amoxicillin

The correct answer is: IV ceftriaxone or cefotaxime

The recommended treatment for meningitis in a college student is intravenous ceftriaxone or cefotaxime. This choice is based on the most common pathogens associated with meningitis in this demographic, particularly Neisseria meningitidis and Streptococcus pneumoniae. Both of these pathogens are covered effectively by ceftriaxone or cefotaxime, which are broad-spectrum cephalosporins. Ceftriaxone is often the preferred choice in emergency settings because of its excellent cerebrospinal fluid penetration and its activity against the organisms most frequently responsible for bacterial meningitis. In addition, cefotaxime is a suitable alternative that offers similar coverage, making both options viable for effectively treating bacterial meningitis. The other treatment options do not address the primary causes of meningitis in this age group adequately. For instance, while IV vancomycin is important for treating antibiotic-resistant strains of Staphylococcus aureus and can be used in cases of suspected meningococcal meningitis, it does not cover Streptococcus pneumoniae and is not the first-line therapy on its own in a case of uncomplicated bacterial meningitis. Intravenous acyclovir is primarily used for viral infections, particularly herpes simplex virus, and is not the