Emerging drugs for acute bacterial meningitis.
The management of acute bacterial meningitis is based on early antibiotic treatment to prevent unfavorable outcome (death and permanent sequelae). beta-Lactam antibiotics, particularly third-generation cephalosporins, are effective against most agents of community-acquired acute bacterial meningitis. Resistance to beta-lactams evolves, particularly in Streptococcus pneumoniae, that may lead to treatment failure. Evaluation of other antibiotics such as fourth-generation cephalosporin, new penems and quinolones is warranted. Adjunctive therapy aims to reduce tissue injuries provoked by the inflammatory response. The use of dexamethasone is still a matter of debate, but seems to be helpful under conditions of rapid etiological diagnosis and prompt management. Other drugs that neutralize bacterial factors or host mechanisms involved in induction of inflammatory response are under development.
Deghmane
Ala-Eddine
AE
Institut Pasteur, National reference centre for meningococci, Invasive Bacterial Infections Provisional Unit, 28 rue du Dr Roux, Paris 75015, France. muhamed.kheir-taha@pasteur.fr
Alonso
Jean-Michel
JM
Taha
Muhamed-Kheir
MK
D000208:Acute Disease; D000818:Animals; D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D000893:Anti-Inflammatory Agents / Q000627:therapeutic use; D001921:Brain / Q000473:pathology; D016207:Cytokines / Q000037:antagonists & inhibitors / Q000096:biosynthesis; D003906:Developing Countries; D004345:Drug Industry; D006801:Humans; D016920:Meningitis, Bacterial / Q000150:complications / Q000188:drug therapy* / Q000382:microbiology / Q000473:pathology
D000900:Anti-Bacterial Agents; D000893:Anti-Inflammatory Agents; D016207:Cytokines