Though viral meningitis may clear up on its own, several other types, including bacterial meningitis, require antibiotic treatment.

Antibiotics treat many bacterial infections by killing bacteria or making it difficult for bacteria to multiply. Antibiotics do not work on viral infections.

In order to be effective, antibiotic treatment must begin quickly after the onset of symptoms. Delays of as little as 3–6 hours increase mortality rates, according to a 2022 paper. Doctors will identify the type of bacteria causing the infection in order to choose the right antibiotic.

Meningitis occurs when an infection causes swelling of the membranes, called meninges, surrounding the brain and spinal cord. The condition is a serious medical emergency.

Read on to learn about the types of meningitis and which antibiotics doctors prescribe to treat each type.

Person holding a pill and a glass of waterShare on Pinterest
Valentina Barreto /Stocksy United

Meningitis is a serious medical condition that requires immediate treatment by a doctor. Most types require treatment in the hospital, although some people can recover from viral meningitis at home.

Bacterial meningitis requires antibiotic treatment to kill the infectious bacteria. The doctor may also prescribe steroids to treat inflammation.

There are several different types of meningitis, some of which are more dangerous than others.

Bacterial meningitis

Several types of bacteria cause bacterial meningitis when they cross the blood-brain, or blood-cerebrospinal, barrier.

In the United States, the leading causes of bacterial meningitis are:

  • Streptococcus pneumoniae
  • Group B Streptococcus
  • Neisseria meningitidis
  • Haemophilus influenzae
  • Listeria monocytogenes
  • Escherichia coli

Which bacteria cause the infection determines the antibiotic chosen for treatment. If diagnosis will take some time, doctors may start early treatment with ceftriaxone and vancomycin.

Anyone who is immunocompromised or over the age of 50 years could also receive ampicillin. After determining which bacteria are involved, the doctor may then de-escalate to a less intensive treatment.

Treatment typically lasts 10–14 days but may last as long as 21 days.

In people with bacterial meningitis due to head trauma or following a surgical procedure, doctors take care to protect against methicillin-resistant Staphylococcus aureus (MRSA). They may prescribe vancomycin and ceftazidime, or cefepime.

For Streptococcus pneumoniae infection, doctors may prescribe dexamethasone along with the antibiotics.

Doctors may also want to treat close contacts with antibiotics as a precaution. Close contacts are people who have been within 3 feet of the individual with the infection for more than 8 hours during the 7 days before, and 24 hours after, receiving antibiotics.

Viral meningitis

Antibiotics do not treat viruses and are ineffective against viral meningitis. Most people with viral meningitis recover on their own in 7–10 days without treatment. The doctor may prescribe an antiviral medication when the infection is caused by influenza or herpesvirus.

Although antibiotics are not the standard of care, individuals who become sick with viral meningitis may still require supportive care in a hospital.

Subacute meningitis

Typically, symptoms of meningitis develop rapidly. Subacute meningitis develops more slowly over a few days to weeks. There are various causes, and the treatment depends on the cause. Possible causes include:

Doctors can treat some of these types of infections with antibiotics.

For tuberculosis meningitis — doctors may prescribe isoniazid and rifampin for 7–10 months following 2 months of treatment with the following antibiotics:

  • isoniazid
  • rifampin
  • pyrazinamide
  • ethambutol

Doctors may add steroids if required for neurologic problems.

For spirochetes, doctors may prescribe cefotaxime or ceftriaxone.

Fungal meningitis

Types of fungi that live in the environment can enter the body and cause fungal meningitis. The fungus Candida that lives in the body and on the skin can also enter the bloodstream of some people who are at risk and cause infection.

Treatment for this type of meningitis includes antifungal medications, including fluconazole, voriconazole, and amphotericin B. Treatment may need to be lifelong.

Tuberculous meningitis

Mycobacterium tuberculosis causes this kind of meningitis, which usually produces symptoms over days or weeks.

In some cases, symptoms develop much more quickly. Doctors generally treat this condition based on suspicion while they await test results to confirm a diagnosis.

Medications for tuberculosis meningitis include the antitubercular drugs isoniazid, rifampin, pyrazinamide, and ethambutol. A doctor may prescribe a corticosteroid such as prednisone or dexamethasone if neurological issues develop.

Syphilitic meningitis

An uncommon presentation of meningitis, syphilitic meningitis may develop into an acute or chronic condition.

A doctor will usually prescribe intravenous penicillin in doses given every 4 hours for 10–14 days.

Parasitic meningitis

Certain parasites cause a rare form of meningitis called eosinophilic meningitis, or eosinophilic meningoencephalitis (EM).

People usually get these parasites by eating contaminated food or infected animals. The most common parasites that cause parasitic meningitis include:

  • Angiostrongylus cantonensis
  • Baylisascaris procyonis
  • Gnathostoma spinigerum

There is no specific treatment for parasitic meningitis. Medications may help relieve pain or support the body as it responds to the parasite.

Lyme meningitis

When Lyme disease bacteria affect the central nervous system, Lyme meningitis can result. This most often occurs early in the Lyme disease process, according to the Centers for Disease Control and Prevention (CDC).

A doctor may prescribe the antibiotic doxycycline for facial palsy due to Lyme disease. For Lyme meningitis, they may also use doxycycline or, alternately, ceftriaxone.

Antibiotics are powerful medications that can treat a variety of conditions. But they do carry side effects, which can be unpleasant for some people.

Common, minor side effects may include:

  • rash
  • nausea
  • diarrhea
  • yeast infection

In some people, more severe side effects may develop, including:

  • C. diff infection, causing diarrhea that can lead to colon damage and even death
  • severe, life threatening allergic reactions
  • antibiotic-resistant infections

It is best to take all antibiotics strictly according to the doctor’s orders and never take them for a condition they do not treat, such as a viral infection or a cold.

Meningitis occurs when an infection causes swelling in the tissues and fluid surrounding the brain and spinal cord. Meningitis has several potential causes, but bacteria and viruses are the most common.

Antibiotics treat a variety of conditions, including bacterial meningitis. They cannot treat viral meningitis as they do not work on viruses.

People can also treat some other forms of meningitis, such as syphilitic and Lyme meningitis, with antibiotics. Doctors can treat other forms with antifungal or antitubercular medications.

All types of meningitis are serious medical emergencies that require a doctor’s care for diagnosis. If any symptoms of meningitis develop, a person should contact a doctor right away.