Current therapy of acute bacterial meningitis in children: Part II

Despite many advances in the past decade in the development of new antimicrobials, acute bacterial meningitis continues to have significant morbidity and mortality in infants and children. Regardless of the effectiveness of the antibiotic preparations, future improvements in outcome is most likely to occur because of more rapid diagnosis and initiation of therapy. The standard penicillins, chloramphenicol, and the aminoglycosides continue to hold an important place in treatment. The recent introduction of new extended spectrum penicillins, including piperacillin and mezlocillin, in addition to the development of the third generation cephalosporins, have expanded alternatives for treating bacterial meningitis. The most appropriate and effective antibiotic or combination of antibiotics must first be selected; thereafter, its use must be monitore to identify its beneficial effects as well as possible adverse effects.