[Bacterial meningitis in Denmark: treatment with dexamethasone and antibiotics].
BACKGROUND
Early adjuvant dexamethasone treatment has been internationally recommended for adults with bacterial meningitis (BM) since 2002. We explored the local recommendations in Denmark concerning treatment with dexamethasone and antibiotics for BM.


METHODS
A questionnaire was sent to all Danish departments of infectious diseases, paediatrics and internal medicine (n = 92) concerning their local treatment recommendations for BM in the period 2002-2004.


RESULTS
The overall response rate was 79%: 100%, 100% and 72%, respectively, for the three departmental types. Early treatment of BM with dexamethasone was recommended in 5 of 5 (100%) departments of infectious diseases, in 13 of 17 (76%) departments of paediatrics and in 22 of 35 (63%) departments of internal medicine. Four, five, and nine different empirical antibiotic regimens were recommended in the departments of infectious diseases, paediatrics, and internal medicine, respectively. In this three-year period, six departments changed their empirical antibiotic regimen: three to a broader-spectrum regimen and three to a regimen with unchanged bacteriological coverage.


CONCLUSIONS
A considerable number of departments of internal medicine (37%) did not include early dexamethasone treatment in their recommendations for BM, despite the international consensus to provide this adjunctive treatment when pneumococcal meningitis is suspected. In addition, a great variation in the recommended empirical antibiotic treatment was demonstrated in this geographically small area.
Meyer
Christian N
CN
Holbaek Centralsygehus, Medicinsk Afdeling. cnm@dadlnet.dk
D000328:Adult; D000667:Ampicillin / Q000008:administration & dosage / Q000627:therapeutic use; D000900:Anti-Bacterial Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D002443:Ceftriaxone / Q000008:administration & dosage / Q000627:therapeutic use; D017024:Chemotherapy, Adjuvant; D002675:Child, Preschool; D003718:Denmark; D005839:Gentamicins / Q000008:administration & dosage / Q000627:therapeutic use; D005938:Glucocorticoids / Q000008:administration & dosage / Q000627:therapeutic use*; D006801:Humans; D016920:Meningitis, Bacterial / Q000188:drug therapy* / Q000382:microbiology; D010406:Penicillins / Q000008:administration & dosage / Q000627:therapeutic use; D017410:Practice Guidelines as Topic; D010818:Practice Patterns, Physicians'; D011795:Surveys and Questionnaires
D000900:Anti-Bacterial Agents; D005839:Gentamicins; D005938:Glucocorticoids; D010406:Penicillins; D002443:Ceftriaxone; D000667:Ampicillin