Jawień Miroslaw, Garlicki Aleksander M
Department of Infectious Diseases, Jagiellonian University Collegium Medicum, Cracov.
Przegl Epidemiol. 2013;67(3):421-7, 529-33.
Bacterial meningitis is associated with significant morbidity and mortality despite the availability of effective antimicrobial therapy. The management approach to patients with suspected or proven bacterial meningitis includes emergent cerebrospinal fluid analysis and initiation of appropriate antimicrobial and adjunctive therapies. The choice of empirical antimicrobial therapy is based on the patient's age and underlying disease status; once the infecting pathogen is isolated, antimicrobial therapy can be modified for optimal treatment. Successful treatment of bacterial meningitis requires the knowledge on epidemiology including prevalence of antimicrobial resistant pathogens, pathogenesis of meningitis, pharmacokinetics and pharmacodynamics of antimicrobial agents. The emergence of antibiotic-resistant bacterial strains in recent years has necessitated the development of new strategies for empiric antimicrobial therapy for bacterial meningitis.
尽管有有效的抗菌治疗方法，但细菌性脑膜炎仍与显著的发病率和死亡率相关。对疑似或确诊的细菌性脑膜炎患者的管理方法包括紧急进行脑脊液分析以及启动适当的抗菌和辅助治疗。经验性抗菌治疗的选择基于患者的年龄和基础疾病状况；一旦分离出感染病原体，就可以调整抗菌治疗以实现最佳治疗效果。成功治疗细菌性脑膜炎需要了解流行病学知识，包括抗菌耐药病原体的流行情况、脑膜炎的发病机制、抗菌药物的药代动力学和药效学。近年来抗生素耐药菌株的出现使得有必要开发细菌性脑膜炎经验性抗菌治疗的新策略。
