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A review of the treatment of bacterial meningitis
N I Girgis1, M E Kilpatrick, Z Farid
1US Naval Medical Research Unit No. 3, Cairo, Egypt.
Abstract:
This is review of our experience in the treatment of meningitis carried out at the Naval Medical Research Unit No. 3 (NAMRU-3), Cairo, Egypt since 1967. We have demonstrated that the serum and cerebrospinal fluid concentrations of ampicillin and its efficacy when used in the treatment of meningitis are comparable whether they are administered intravenously or intramuscularly. The third generation cephalosporin ceftriaxone was found to be very safe and effective when administered intramuscularly once a day in the treatment of the different types of acute bacterial meningitis. Aztreonam given intramuscularly was successful in the treatment of Gram-negative meningitis caused by multi-resistant organisms. The fatality rates and morbidity were significantly reduced in patients with meningitis when dexamethasone was given in conjunction with antibacterial chemotherapy.
Insights
Ampicillin administered intravenously or intramuscularly shows comparable efficacy for meningitis treatment. Third-generation cephalosporins and aztreonam are effective, and dexamethasone reduces fatality rates in bacterial meningitis.
Area of Science:
- Infectious Diseases
- Pharmacology
- Neurology
Background:
- Meningitis remains a significant cause of mortality and morbidity worldwide.
- Effective treatment strategies are crucial for improving patient outcomes.
- Evaluating antibiotic efficacy and adjunctive therapies is essential for clinical practice.
Purpose of the Study:
- To review experience in meningitis treatment at NAMRU-3, Cairo since 1967.
- To compare intravenous versus intramuscular administration of ampicillin for meningitis.
- To assess the efficacy and safety of ceftriaxone, aztreonam, and dexamethasone in meningitis management.
Main Methods:
- Retrospective review of clinical experience with meningitis treatment.
- Analysis of serum and cerebrospinal fluid concentrations of ampicillin.
- Evaluation of treatment outcomes for ceftriaxone, aztreonam, and dexamethasone therapies.
Main Results:
- Ampicillin efficacy and concentrations were comparable via intravenous and intramuscular routes.
- Ceftriaxone demonstrated safety and efficacy when given intramuscularly once daily for acute bacterial meningitis.
- Aztreonam was successful in treating Gram-negative meningitis caused by multi-resistant bacteria.
- Dexamethasone, combined with antibacterial chemotherapy, significantly reduced fatality rates and morbidity in meningitis patients.
Conclusions:
- Intramuscular ampicillin is a viable alternative to intravenous administration for meningitis.
- Third-generation cephalosporins like ceftriaxone offer effective once-daily intramuscular treatment options.
- Aztreonam provides a treatment option for meningitis due to multi-resistant Gram-negative organisms.
- Dexamethasone is a valuable adjunctive therapy for reducing complications in bacterial meningitis.