Stille W, Helm E
MMW Munch Med Wochenschr. 1976 Dec 3;118(49):1603-8.
For the specific and unspecific treatment of purulent meningitis, penicillin, ampicillin and chloramphenicol are usually sufficient. Only resistant pathogens (Klebsiella, Pseudomonas among others) and meningitis in infants require other treatment. Cephalosporins and aminoglycosides only come into consideration for the treatment of very rare exceptional cases. The still relatively poor prognosis of purulent meningitis is largely independent of the efficacy of the treatment. Delay in beginning therapy, lack of intensive care, primary diseases and complications are principally responsible for this. Medicamentous prophylaxis is only possible for meningococcal meningitis. The distribution of antibiotics in the CSF is irregular. Also the antibacterial activity in the CSF is different from culture media.
对于化脓性脑膜炎的特异性和非特异性治疗，青霉素、氨苄西林和氯霉素通常就足够了。只有耐药病原体（如克雷伯菌、铜绿假单胞菌等）以及婴儿脑膜炎需要其他治疗。头孢菌素和氨基糖苷类仅在治疗非常罕见的特殊病例时才会被考虑。化脓性脑膜炎相对较差的预后在很大程度上与治疗效果无关。治疗开始延迟、缺乏重症监护、原发性疾病和并发症是主要原因。药物预防仅适用于脑膜炎球菌性脑膜炎。抗生素在脑脊液中的分布不规则。脑脊液中的抗菌活性也与培养基不同。
