[Initial antibiotic therapy of purulent meningitis in adults. An investigation of practice patterns at Danish hospital department in 2000].
BACKGROUND
A previous report demonstrated profound variation in the recommended empirical antibiotic therapy for adult purulent meningitis in Denmark. At present, the only existing "official" recommendation (from the Danish Medical Association) is penicillin monotherapy for all adults, irrespective of age, as the prevalence of penicillin-resistant pneumococci is less than 3%.


METHODS
A questionnaire concerning empirical antibiotic therapy and the treatment of specific microorganisms was sent to the 125 departments of internal medicine, infectious diseases, clinical microbiology, neurosurgery, otorhinolaryngology, and neurology in 2001.


RESULTS
Consensus was not found in the 93% who replied, neither within or between the medical specialties nor within or between the counties. The departments of medicine and clinical microbiology were evenly distributed between two strategies: 1) a third-generation cephalosporin plus a penicillin, or 2) penicillin monotherapy, in supplemented in few departments with an aminoglycoside. For Haemophilus influenzae meningitis, 20% of the departments used ampicillin, whereas the majority preferred ceftriaxone.


CONCLUSIONS
Consensus on empirical antibiotic treatment of purulent meningitis in adults had still not been reached in Denmark in the year 2000, and regimens other than that recommended by the Danish Medical Association were used. Complete and updated information is lacking on the resistance-patterns of bacteria inducing meningitis, and a complete national clinical microbiological database could form the basis for an evidence-based national consensus.
Meyer
Christian N
CN
Intern medicinsk klinik I, H:S Bispebjerg Hospital, DK-2400 København NV.
D000328:Adult; D000900:Anti-Bacterial Agents / Q000008:administration & dosage*; D032921:Consensus; D003718:Denmark; D004359:Drug Therapy, Combination / Q000008:administration & dosage; D006801:Humans; D016920:Meningitis, Bacterial / Q000188:drug therapy*; D017410:Practice Guidelines as Topic; D010818:Practice Patterns, Physicians'; D011795:Surveys and Questionnaires
D000900:Anti-Bacterial Agents