Theoretical and Practical Considerations of Antibiotic Therapy for Bacterial Meningitis

2015 ◽  
pp. 96-117 ◽  
Author(s):  
Carole A. Sable ◽  
W. Michael Scheld
Keyword(s):  
Bacterial Meningitis ◽  
Antibiotic Therapy

The Frequency of Pericardial Effusions in Bacterial Meningitis

PEDIATRICS ◽  
1979 ◽  
Vol 63 (5) ◽  
pp. 764-770
Author(s):  
W. Pennock Laird ◽  
John D. Nelson ◽  
F. Douglas Huffines
Keyword(s):  
Risk Factors ◽  
Bacterial Meningitis ◽  
Antibiotic Therapy ◽  
Significant Risk ◽  
Literature Survey ◽  
The Other ◽  
Purulent Pericarditis ◽  
Pericardial Effusions ◽  
In Series ◽  
A Prospective Study

Because of our experience with four cases of purulent pericarditis complicating bacterial meningitis during a 13-month period, we performed a prospective study to determine the frequency of this complication. Echocardiograms were done on 100 patients with bacterial meningitis. Small or moderate pericardial effusions were detected in 19 patients, but none had symptoms or signs related to the effusion. Pericardiocentesis was done in one infant; all the other effusions resolved spontaneously. Patients with effusion were significantly younger than those without this complication, but no other significant risk factors were identified. A literature survey indicated that symptomatic pericarditis occurs in fewer than 1% of patients with meningitis. Conversely, in series of cases of purulent pericarditis, associated meningitis was reported in 12% of patients. We concluded that pericardial infection is common in patients with meningitis but that it is usually of no clinical significance and resolves with antibiotic therapy.

scholarly journals Effect of Antibiotic Pretreatment on Cerebrospinal Fluid Profiles of Children with Acute Bacterial Meningitis

2013 ◽  
Vol 2 (2) ◽  
pp. 135-139 ◽  
Author(s):  
S Adhikari ◽  
E Gauchan ◽  
G BK ◽  
KS Rao
Keyword(s):  
Cerebrospinal Fluid ◽  
Bacterial Meningitis ◽  
Antibiotic Therapy ◽  
Lumbar Puncture ◽  
Laboratory Finding ◽  
Clinical Findings ◽  
Acute Bacterial Meningitis ◽  
Antibiotic Administration ◽  
Intravenous Antibiotic ◽  
Considerable Difficulty

Background: Analysis of cerebrospinal fluid is gold standard for diagnosis of meningitis. There is considerable difficulty in interpreting laboratory finding after prior antibiotic therapy. This study was conducted to evaluate the effect of intravenous antibiotic administration before lumbar puncture on cerebrospinal fluid profiles in children with bacterial meningitis. Methods: A hospital based retrospective study carried out using the data retrieved from the medical record department of Manipal Teaching Hospital Pokhara, Nepal; from 1st July 2006 to 31st July 2011. Clinical findings and relevant investigations were entered in a predesigned proforma. Patients were divided in two different groups as bacterial meningitis with and without prior intravenous antibiotic therapy. Various laboratory parameters including CSF were compared between these two groups using the statistical software, SPSS version 18.0. Results: A total of 114 children were included in this study among which 49(43%) children had received intravenous antibiotics before lumbar puncture. Mean CSF WBC count was(267.6± 211 vs. 208.1±125.3.3) and protein level (114.1±65.9 vs. 98.3±37.7mg/dl) in untreated vs. pretreated groups respectively. Neutrophil percentage was decreased (57.1±28.1vs.72.9±18.9) with higher CSF sugar level (43.3±11.8 vs. 51.2±13.2) after prior antibiotics therapy (p<0.001). Conclusion: Antibiotic pretreatment was associated with higher cerebrospinal fluid glucose levels with decreased neutrophils and increased lymphocytes. Pretreatment did not modify total cerebrospinal fluid white blood cell count and cerebrospinal fluid protein levels. Nepal Journal of Medical Sciences | Volume 02 | Number 02 | July-December 2013 | Page 135-139 DOI: http://dx.doi.org/10.3126/njms.v2i2.8963

Pediatric bacterial meningitis: Is prior antibiotic therapy associated with an altered clinical presentation?

1992 ◽  
Vol 21 (2) ◽  
pp. 146-152 ◽  
Author(s):  
Steven G Rothrock ◽  
Steven M Green ◽  
Joseph Wren ◽  
Debbie Letai ◽  
Lynda Daniel-Underwood ◽  
...  
Keyword(s):  
Bacterial Meningitis ◽  
Antibiotic Therapy ◽  
Clinical Presentation ◽  
Prior Antibiotic Therapy

scholarly journals Impact of a multiplex polymerase chain reaction panel on duration of empiric antibiotic therapy in suspected bacterial meningitis

2021 ◽  
Author(s):  
Justin J Choi ◽  
Lars F Westblade ◽  
Lee S Gottesdiener ◽  
Kyle Liang ◽  
Han A Li ◽  
...  
Keyword(s):  
Bacterial Meningitis ◽  
Antibiotic Therapy ◽  
Multiplex Pcr ◽  
Hospital Length ◽  
Clinical Impact ◽  
Hospital Length Of Stay ◽  
Empiric Antibiotic Therapy ◽  
Chain Reaction ◽  
Empiric Antibiotic ◽  
Polymerase Chain

Abstract Background Multiplex polymerase chain reaction (PCR) panels allow for rapid detection or exclusion of pathogens causing meningitis and encephalitis (ME). The clinical impact of rapid multiplex PCR ME panel results on the duration of empiric antibiotic therapy is not well characterized. Methods We performed a retrospective pre-post study at our institution that evaluated the clinical impact of a multiplex PCR ME panel among adults with suspected bacterial meningitis who received empiric antibiotic therapy and underwent lumbar puncture in the emergency department. The primary outcome was the duration of empiric antibiotic therapy. Results The positive pathogen detection rates were similar between pre- and post-multiplex PCR ME panel periods (17.5%, 24 of 137, vs. 20.3%, 14 of 69, respectively). The median duration of empiric antibiotic therapy was significantly reduced in the post-multiplex PCR ME panel period compared to the pre-multiplex PCR ME panel period (34.7 h vs. 12.3 h, P=0.01). At any point in time, 46% more patients in the post-multiplex PCR ME panel period had empiric antibiotic therapy discontinued or de-escalated compared to the pre-multiplex PCR ME panel period (sex- and immunosuppressant use-adjusted HR 1.46, P=0.01). The median hospital length of stay was shorter in the post-multiplex PCR ME panel period (3 d vs. 4 d, P=0.03). Conclusions The implementation of the multiplex PCR ME panel for bacterial meningitis reduced the duration of empiric antibiotic therapy and possibly hospital length of stay compared to traditional microbiological testing methods.

Acute Bacterial Meningitis

2017 ◽  
Author(s):  
Pratibha Singhi ◽  
Naveen Sankhyan ◽  
Sunit Singhi
Keyword(s):  
Bacterial Meningitis ◽  
Antibiotic Therapy ◽  
Supportive Care ◽  
Pathogenic Bacteria ◽  
Neuronal Damage ◽  
Current Understanding ◽  
Acute Bacterial Meningitis ◽  
Clinical Aspects ◽  
Inflammatory Cascade ◽  
Cytokines And Chemokines

Bacterial meningitis is one of the severest infections in childhood. Neuronal damage in meningitis is largely due to the extensive inflammatory cascade induced by pathogenic bacteria. This chapter discusses the current understanding of the interaction of multitude of factors in the pathogenesis of bacterial meningitis. This includes the mechanisms involved in transcellular traversal of the bacteria, and induction and release of several inflammatory cytokines and chemokines. The management of a child with bacterial meningitis requires meticulous supportive care and timely, appropriate, and adequate antibiotic therapy. The chapter also reviews the current understanding of some important clinical aspects of care of a child with bacterial meningitis.

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