Current Management of Common Bacterial Meningitides
Sheldon L. Kaplan MD1
1 Associate Professor of Pediatrics, Baylor College of Medicine; Chief, Infectious Disease Service Texas Children's Hospital, 6621 Fannin, Houston, TX 77030
Bacterial meningitis is one of the most important, relatively frequent life-threatening infections encountered in children; thus physicians caring for children must be familiar with the current recommendations concerning its management. Newer antibiotics, especially third-generation cephalosporins, have provided satisfactory alternatives to the standard antibiotic treatment of bacterial meningitis in children but present the pediatrician with a baffling array of potential choices that can lead to confusion and indecision when selecting an agent to administer. At the present time, none of these newer agents has emerged as clearly superior to the others, and, therefore, a particular agent cannot be recommended as the single drug of choice for the treatment of bacterial meningitis in the pediatric age group. This review will focus on the antibiotic treatment and supportive care of the child with bacterial meningitis due to the most common pathogens
ANTIMICROBIAL THERAPY OF BACTERIAL MENINGITIS IN CHILDREN
The principles of the antibiotic therapy of bacterial meningitis have been derived from both clinical studies and animal models.1 It is clear that an antibiotic must be bactericidal in vitro against a particular microorganism in order to be most effective in vivo. Antibiotics that only inhibit growth of an organism frequently do not result in sterility of CSF in animal models or in the human host.
