- All children with fever and a haemorrhagic rash
- Children with shock with or without a rash
- Children with clinical evidence of meningitis. If lumbar puncture is contraindicated, treat immediately with antibiotics and lumbar puncture when safe (but full set of bloods as well as throat swabs for culture should be taken if not already done). Consider adjunctive dexamethasone before, with or within 4 hours of the first dose of antibiotics, if there are no signs of septic shock42
Door to needle time
43
Once the decision to give antibiotics has been taken, ensure they are written up and given within 30 minutes. Unacceptable delays in giving antibiotics can occur when responsibility for this is delegated without personal follow up.