Bacterial meningitis: current therapy and possible future treatment options.
Despite targeted therapy, case-fatality rates and neurologic sequelae of bacterial meningitis remain unacceptably high. The poor outcome is mainly due to secondary systemic and intracranial complications. These complications seem to be both a consequence of the inflammatory response to the invading pathogen and release of bacterial components by the pathogen itself. Therefore, within the last decades, research has focused on the mechanism underlying immune regulation and the inhibition of bacterial lysis in order to identify new targets for adjuvant therapy. The scope of this article is to give an overview on current treatment strategies of bacterial meningitis, to summarize new insights on the pathophysiology of bacterial meningitis, and to give an outlook on new treatment strategies derived from experimental models.
Department of Neurology, Klinikum Grosshadern, Ludwig Maximilians University, Munich, Germany.
Bianca
B
Woehrl
Matthias
M
Klein
Denis
D
Grandgirard
Uwe
U
Koedel
Stephen
S
Leib
D000293:Adolescent; D000328:Adult; D000368:Aged; D000818:Animals; D000900:Anti-Bacterial Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D000893:Anti-Inflammatory Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D017209:Apoptosis; D002675:Child, Preschool; D019468:Disease Management; D004195:Disease Models, Animal; D004334:Drug Administration Schedule; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D016920:Meningitis, Bacterial / Q000188:drug therapy* / Q000382:microbiology / Q000503:physiopathology; D051379:Mice; D008875:Middle Aged; D009345:Neisseria meningitidis / Q000187:drug effects* / Q000502:physiology; D009504:Neutrophils / Q000187:drug effects / Q000382:microbiology; D012307:Risk Factors; D013296:Streptococcus pneumoniae / Q000187:drug effects* / Q000502:physiology; D013346:Subarachnoid Space / Q000187:drug effects* / Q000382:microbiology / Q000503:physiopathology; D013997:Time Factors
D000900:Anti-Bacterial Agents; D000893:Anti-Inflammatory Agents