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Treatment with Vancomycin Loaded Calcium Sulphate and Autogenous Bone in an Improved Rabbit Model of Bone Infection
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Vancomycin Should Be Part of Empiric Therapy for Suspected Bacterial Meningitis

Liset Olarte1

  • 1Division of Infectious Diseases, Children's Mercy Hospital, Kansas City, Missouri.

Journal of the Pediatric Infectious Diseases Society
|November 30, 2018
PubMed

Insights

Empiric vancomycin plus a third-generation cephalosporin is recommended for bacterial meningitis. Despite decreased ceftriaxone-nonsusceptible pneumococcal meningitis, vancomycin remains crucial for empiric therapy.

Area of Science:

  • Infectious Diseases
  • Microbiology
  • Neurology

Background:

  • Empiric antibiotic therapy for bacterial meningitis has long relied on vancomycin and third-generation cephalosporins.
  • Established guidelines since 1997 recommend this combination for suspected cases.

Purpose of the Study:

  • To evaluate the continued necessity of vancomycin in empiric bacterial meningitis treatment.
  • To assess the impact of decreasing ceftriaxone resistance on treatment recommendations.

Main Methods:

  • Review of historical treatment guidelines for bacterial meningitis.
  • Analysis of trends in pneumococcal meningitis susceptibility to ceftriaxone.

Main Results:

  • The prevalence of ceftriaxone-nonsusceptible pneumococcal meningitis has shown a declining trend.
  • Despite this decrease, the overall risk profile for bacterial meningitis necessitates continued broad-spectrum coverage.

Conclusions:

  • Vancomycin should remain a component of empiric therapy for suspected bacterial meningitis.
  • This recommendation is based on the persistent need for coverage against resistant pathogens and the overall severity of the disease.
Keywords:
Streptococcus pneumoniaebacterial meningitispediatricvancomycin

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