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Acute Bacterial Meningitis in ChildrenTexas Tech University, HSC School of Pharmacy, 1300 S. Coulter, Suite 206, Amarillo, TX 79106-1712mark.haase{at}ttuhsc.edu Despite advances in recent decades in management, including new and effective antimicrobials, children with bacterial meningitis still incur significant morbidity and mortality. Pathophysiologic processes including colonization and migration of the bacteria to blood, seeding of the meninges, and meningeal and brain inflammation have been largely elucidated, but more specific knowledge could lead to new effective therapies. Outside of the neonatal period, the most common causative organisms have been Haemophilus influenzae, Streptococcus pneumoniae, and Neisseria meningitidis. However, conjugate vaccines, especially the H influenzae type b preparation, have contributed significantly to steep declines in the incidence of meningitis. Optimal management consists of rapid diagnosis and administration of bactericidal antibiotics with properties allowing adequate penetration of the inflamed blood-brain barrier. Recently, development of microbial resistance has resulted in changes to recommended empiric antibiotic regimens. Novel therapies are under investigation; however, until controlled trials can be conducted, these therapies cannot be recommended.
Key Words: Meningitis • pediatric • antibiotics • dexamethasone
Journal of Pharmacy Practice, Vol. 17, No. 6,
392-406 (2004) |
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