Antibiotic treatment of community acquired bacterial meningitis.
Community acquired meningitis is predominantly caused by three agents: Haemophilus influenzae, Streptococcus pneumoniae and Neisseria meningitidis Four physical properties of available drugs--molecular size, protein binding, lipid solubility and ionization--affect drug entry to the central nervous system (CNS). These factors, coupled with acute changes in blood-brain barriers and intrinsic bactericidal activity, have a bearing on the success of treatment with all agents. Third generation cephalosporins have largely supplanted older regimens due to their intrinsic qualities of greater bactericidal activity, optimal cerebrospinal fluid pharmacokinetics, and low toxicity. The pharmacological principles of treatment of CNS bacterial infections, pharmacology of available drugs, and current treatment recommendations are reviewed.
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Department of Pediatrics, University of New Mexico, Albuquerque.
D000900:Anti-Bacterial Agents / Q000493:pharmacokinetics / Q000627:therapeutic use; D001693:Biological Transport, Active; D001812:Blood-Brain Barrier; D006801:Humans; D008563:Membrane Lipids; D016920:Meningitis, Bacterial / Q000188:drug therapy*; D008970:Molecular Weight; D011485:Protein Binding; D012995:Solubility; D014390:Tuberculosis, Meningeal / Q000188:drug therapy
D000900:Anti-Bacterial Agents; D008563:Membrane Lipids