[Pathophysiology of neuronal injury in bacterial meningitis and experimental adjunctive therapeutic approaches].
In bacterial meningitis, death and long-term neurological sequelae are caused jointly by several factors. Despite highly qualified intensive care and effective antibacterial therapy mortality rates remain high. Beta-lactam antibiotics, currently used for initial therapy of bacterial meningitis, lead to a rapid lysis of bacteria with a consecutive profound release of proinflammatory bacterial cell wall components, causing a substantial burst of meningeal inflammation. The only approved adjunctive therapy so far is corticosteroids. The use of nonbacteriolytic, protein-synthesis inhibiting antibiotics in experimental models of pneumococcal meningitis appeared to be a promising therapeutic approach towards neuroprotection by diminishing the inflammatory process.
Böttcher
T
T
Dietrich-Bonhoeffer-Klinikum, Klinik für Neurologie, S.-Allende-Strasse 30, Neubrandenburg. toboettcher@gmx.de
D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D000893:Anti-Inflammatory Agents / Q000627:therapeutic use; D017024:Chemotherapy, Adjuvant; D006801:Humans; D016920:Meningitis, Bacterial / Q000150:complications* / Q000188:drug therapy / Q000382:microbiology* / Q000473:pathology / Q000628:therapy*; D009422:Nervous System Diseases / Q000209:etiology* / Q000473:pathology / Q000628:therapy*; D013256:Steroids / Q000627:therapeutic use
D000900:Anti-Bacterial Agents; D000893:Anti-Inflammatory Agents; D013256:Steroids