**Core Concept**
Pneumococcal meningitis, caused by Streptococcus pneumoniae, is a life-threatening infection requiring prompt antibiotic treatment. The choice of empirical antibiotic is crucial until culture sensitivity results are available.

**Why the Correct Answer is Right**
Cefotaxime and vancomycin are the recommended empirical antibiotics for suspected pneumococcal meningitis. Cefotaxime is a third-generation cephalosporin with excellent penetration into the cerebrospinal fluid (CSF) and broad-spectrum activity against Streptococcus pneumoniae. Vancomycin is added to cover for potential resistance, particularly in cases of penicillin-resistant S. pneumoniae. This combination provides broad-spectrum coverage and is effective against most strains of S. pneumoniae.

**Why Each Wrong Option is Incorrect**
**Option A:** Penicillin G is the traditional treatment for pneumococcal meningitis, but its use is limited by the increasing prevalence of penicillin-resistant S. pneumoniae strains.
**Option B:** Ceftriaxone is a third-generation cephalosporin, but it is not as effective as cefotaxime in penetrating the CSF, and metronidazole is not indicated for pneumococcal meningitis.
**Option C:** Doxycycline has no role in the treatment of pneumococcal meningitis and is not effective against Streptococcus pneumoniae.

**Clinical Pearl / High-Yield Fact**
In cases of suspected pneumococcal meningitis, empirical antibiotic therapy should be initiated promptly, and the combination of cefotaxime and vancomycin is recommended until culture sensitivity results are available.

**✓ Correct Answer: D. Cefotaxime + vancomycin**