Treatment of bacterial meningitis.

Bacterial meningitis remains a life-threatening infection at any age, and prompt, adequate treatment is of great prognostic importance. Due to the special features of the meninges as a site of infection, many problems are associated with antimicrobial therapy. Approximately 80% of the patients with bacterial meningitis belong to the pediatric age group, and the three principal pathogens are Haemophilus influenzae type b, Neisseria meningitidis and Streptococcus pneumoniae. The diagnostic requirements essential for satisfactory management are defined and the antibiotic therapy of meningitis is discussed in detail. Data obtained from both experimental and clinical meningitis are indicative that a minimum bactericidal titre of 1:10 should be achieved in the cerebrospinal fluid for optimal therapeutic results. Recommendations are given for specific antimicrobial treatment according to patient's age and causative organism, as well as guidelines for further lumbar punctures, duration of therapy and prophylaxis, with emphasis on the important role of the newer cephalosporin compounds in treatment of meningitis.