Böttcher T
Dietrich-Bonhoeffer-Klinikum, Klinik für Neurologie, S.-Allende-Strasse 30, Neubrandenburg.
Fortschr Neurol Psychiatr. 2009 Aug;77 Suppl 1:S7-9. doi: 10.1055/s-0028-1109593. Epub 2009 Aug 14.
In bacterial meningitis, death and long-term neurological sequelae are caused jointly by several factors. Despite highly qualified intensive care and effective antibacterial therapy mortality rates remain high. Beta-lactam antibiotics, currently used for initial therapy of bacterial meningitis, lead to a rapid lysis of bacteria with a consecutive profound release of proinflammatory bacterial cell wall components, causing a substantial burst of meningeal inflammation. The only approved adjunctive therapy so far is corticosteroids. The use of nonbacteriolytic, protein-synthesis inhibiting antibiotics in experimental models of pneumococcal meningitis appeared to be a promising therapeutic approach towards neuroprotection by diminishing the inflammatory process.
在细菌性脑膜炎中，死亡和长期神经后遗症是由多种因素共同导致的。尽管有高质量的重症监护和有效的抗菌治疗，但死亡率仍然很高。目前用于细菌性脑膜炎初始治疗的β-内酰胺类抗生素会导致细菌迅速裂解，随之促炎性细菌细胞壁成分大量释放，引发脑膜炎症的大幅爆发。迄今为止唯一被批准的辅助治疗方法是使用皮质类固醇。在肺炎球菌性脑膜炎的实验模型中，使用非溶菌性、抑制蛋白质合成的抗生素似乎是一种通过减轻炎症过程来实现神经保护的有前景的治疗方法。
