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Community-acquired bacterial meningitis in adults: antibiotic timing in disease course and outcome

D Lepur1, B Barsić

  • 1Department for Neuroinfections and Center for Intensive Care Medicine, University Hospital for Infectious Diseases "Dr. Fran Mihaljević", Mirogojska 8, 10000 Zagreb, Croatia. lepurix@inet.hr

Infection
|July 25, 2007
PubMed
Abstract

Insights

Early antibiotic treatment for bacterial meningitis significantly improves patient outcomes. Delays in administering antibiotics, especially concerning consciousness disturbance, are linked to unfavorable results and increased mortality.

Area of Science:

  • Infectious Diseases
  • Neurology
  • Clinical Medicine

Background:

  • Bacterial meningitis remains a significant cause of mortality in adults, despite advances in care.
  • Optimizing treatment timing is crucial for improving patient outcomes in bacterial meningitis.

Purpose of the Study:

  • To evaluate the impact of antibiotic administration timing on the course and outcome of bacterial meningitis.
  • To identify critical time windows for antibiotic treatment in relation to disease progression and patient status.

Main Methods:

  • Retrospective cohort study of 286 adult patients with community-acquired bacterial meningitis (1990-2004).
  • Analysis of antibiotic timing relative to disease onset, consciousness disturbance, and hospital admission.
  • Subgroup analysis in 176 culture-positive meningitis patients with altered mental status.

Main Results:

  • Unfavorable outcomes occurred in 43.7% of patients.
  • Delayed antibiotic treatment, particularly in relation to consciousness disturbance, was significantly associated with poor outcomes (p < 0.001).
  • Early adequate antibiotic treatment was an independent predictor of favorable outcome (OR = 11.19; p < 0.001) in culture-positive cases with altered mental status.
  • Advanced age, lower Glasgow Coma Scale (GCS) scores, and seizures were identified as independent risk factors for poor outcomes.

Conclusions:

  • Early and adequate antibiotic administration is critical for improving outcomes in bacterial meningitis.
  • Timely intervention significantly enhances the likelihood of a favorable prognosis for patients with bacterial meningitis.

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