Therapeutic management of bacterial meningitis in children: a systematic review and comparison of published guidelines from a European perspective.
Bacterial meningitis is an infectious disease emergency that can cause substantial morbidity and mortality. We compared the most recent international guidelines and recommendations on bacterial meningitis management in infants and children in developed countries, in terms of initial management approach, empirical antimicrobial therapy, timing, dosages, and duration of antimicrobial therapy, and possible adjunctive treatment with dexamethasone. Secondly, epidemiological data on bacterial resistance in several european countries were analyzed and discussed in relation to the therapies currently recommended for bacterial meningitis. The comparative analysis of the selected guidelines highlighted significant differences in the therapeutic management of bacterial meningitis. Differences among guidelines have important consequences for daily practice. An agreed protocol for early, evidence-based, and effective therapeutic management of bacterial meningitis is essential for the best outcome. further studies and expert consensus are required to establish the best management of bacterial meningitis in the european setting based on the most recent epidemiological data on resistance rates.
DE Gaudio
M
M
Department of Pediatrics, University of Florence, Florence, Italy.
Chiappini
E
E
Galli
L
L
DE Martino
M
M
D000305:Adrenal Cortex Hormones / Q000627:therapeutic use; D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D002648:Child; D002675:Child, Preschool; D002986:Clinical Trials as Topic; D003907:Dexamethasone / Q000627:therapeutic use; D004352:Drug Resistance, Microbial; D005060:Europe; D017408:Guidelines as Topic; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D016920:Meningitis, Bacterial / Q000188:drug therapy*
D000305:Adrenal Cortex Hormones; D000900:Anti-Bacterial Agents; D003907:Dexamethasone