Thys J P
Resuscitation. 1984 Mar;11(3-4):243-8. doi: 10.1016/0300-9572(84)90021-2.
In the clinical approach of bacterial meningitis, the following points are stressed. Rapid identification of the germ, pending the results of the cultures. Various laboratory procedures are reviewed such as the Gram stain, the counterimmunoelectrophoresis, lactate determination and limulus assay of the CSF. Because of the local impaired host defences as well as the poor penetration and partial bioinactivation of most of the antibiotics in the CSF, large doses of the drugs are necessary to ensure sufficient levels and bactericidal titers. Specific antimicrobial therapy of meningitis is reviewed, with an emphasis on the third generation cephalosporins which appears to be the key to the treatment of Gram negative infections.
在细菌性脑膜炎的临床治疗中，需强调以下几点。在培养结果出来之前快速鉴定病原菌。回顾各种实验室检查方法，如脑脊液的革兰氏染色、对流免疫电泳、乳酸测定和鲎试剂检测。由于局部宿主防御功能受损，以及大多数抗生素在脑脊液中的渗透性差和部分生物失活，需要大剂量用药以确保足够的血药浓度和杀菌效价。综述了脑膜炎的特异性抗菌治疗，重点是第三代头孢菌素，它似乎是治疗革兰氏阴性菌感染的关键。
