细菌性脑膜炎的治疗策略和新进展。

Strategies and new developments in the management of bacterial meningitis.

机构信息

Department of Internal Medicine, Division of Infectious Diseases, Baystate Medical Center, 759 Chestnut Street, Springfield, MA 01199, USA.

出版信息

Infect Dis Clin North Am. 2009 Dec;23(4):925-43, viii-ix. doi: 10.1016/j.idc.2009.06.014.

DOI:10.1016/j.idc.2009.06.014

PMID:19909891

Abstract

The principles of antimicrobial therapy for acute bacterial meningitis include use of agents that penetrate well into cerebrospinal fluid and attain appropriate cerebrospinal fluid concentrations, are active in purulent cerebrospinal fluid, and are bactericidal against the infecting pathogen. Recommendations for treatment of bacterial meningitis have undergone significant evolution in recent years, given the emergence of pneumococcal strains that are resistant to penicillin. Clinical experience with use of newer agents is limited to case reports, but these agents may be necessary to consider in patients who are failing standard therapy.

摘要

急性细菌性脑膜炎的抗菌治疗原则包括使用能够很好地穿透脑脊液并达到适当脑脊液浓度的药物，对脓性脑脊液具有活性，并且对感染病原体具有杀菌作用。鉴于青霉素耐药的肺炎球菌菌株的出现，近年来细菌性脑膜炎的治疗建议发生了重大变化。使用新型药物的临床经验仅限于病例报告，但对于正在接受标准治疗的患者，可能需要考虑这些药物。