Bacterial meningitis: new therapeutic approaches.
Bacterial meningitis remains a disease with high mortality and long-term morbidity. Outcome critically depends on the rapid initiation of effective antibiotic therapy. Since a further increase of the incidence of pathogens resistant to antibacterials can be expected both in community-acquired and nosocomial bacterial meningitis, the choice of an optimum initial empirical antibiotic regimen will gain significance. In this context, the use of antibiotics which are bactericidal but do not lyse bacteria, may emerge as a therapeutic option. Conversely, the role of corticosteroids, which decrease the entry of hydrophilic antibacterials into the cerebrospinal fluid, as adjunctive therapy will probably decline as a consequence of the increasing antibiotic resistance of bacteria causing meningitis. Consequent vaccination of all children at present is the most efficient manner to reduce disease burden.
Department of Geriatrics, Evangelisches Krankenhaus Göttingen-Weende, An der Lutter 24, 37075 Göttingen, Germany.
Roland
R
Nau
Marija
M
Djukic
Annette
A
Spreer
Helmut
H
Eiffert
D000305:Adrenal Cortex Hormones / Q000627:therapeutic use; D000328:Adult; D000368:Aged; D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D001921:Brain / Q000187:drug effects / Q000382:microbiology / Q000473:pathology; D002648:Child; D004334:Drug Administration Schedule; D024881:Drug Resistance, Bacterial; D006801:Humans; D007231:Infant, Newborn; D008089:Listeria monocytogenes / Q000187:drug effects / Q000472:pathogenicity / Q000502:physiology; D016920:Meningitis, Bacterial / Q000175:diagnosis / Q000382:microbiology / Q000517:prevention & control / Q000628:therapy*; D022401:Meningococcal Vaccines / Q000096:biosynthesis / Q000276:immunology; D009345:Neisseria meningitidis / Q000187:drug effects / Q000472:pathogenicity / Q000502:physiology; D013296:Streptococcus pneumoniae / Q000187:drug effects / Q000472:pathogenicity / Q000502:physiology
D000305:Adrenal Cortex Hormones; D000900:Anti-Bacterial Agents; D022401:Meningococcal Vaccines