Bacterial Meningitis: Principles and Practical Aspects of Therapy

Acute bacterial meningitis continues to be associated with significant morbidity and mortality. Recent research efforts to improve outcome for such patients have focused on antibiotic-cerebrospinal fluid interactions, factors influencing antibiotic selection, indications for cranial imaging, the role of anti-inflammatory agents, and the impact of antibiotic timing on outcome. In this article, I use an illustrative case to review timely data on these topics and provide guidelines for the empiric and pathogen-directed treatment of patients with acute bacterial meningitis.