Therapy of community-acquired acute bacterial meningitis: the clock is running

Abstract

Despite antibiotic therapy and supportive intensive medical care, bacterial meningitis remains a disease with high mortality and morbidity. Rapid recognition of symptoms is crucial to direct physicians quickly towards appropriate diagnostic measures and, initially, empiric antibiotic therapy. It has become evident that time from arrival at the hospital to application of the first dose of antibiotics is a crucial independent factor that influences outcome. Here, we review the clinical and laboratory presentation of community-acquired bacterial meningitis and the antibiotic regiments that are currently recommended for its treatment; future therapeutic options are also discussed. Finally, suggestions for the approach to a patient with suspected bacterial meningitis are presented.

Keywords::

• antibiotic therapy
• bacterial
• CNS infection
• meningitis
• Neisseria meningitidis
• Streptococcus pneumoniae

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Acknowledgements

The authors thank the European Society of Clinical Microbiology and Infectious Diseases (ESCMID) for funding of the ESCMID Meningitis Study Group (EMESG) and, thus, providing a platform for concerted research on bacterial meningitis. The financial add of the Meningitis Research Foundation (MRF), the Deutsche Forschungsgemeinschaft (DFG), the University of Munich (FöFoLe), the Friedrich Baur Stiftung, and the Else Kroener Fresenius Foundation (EKFS) is highly appreciated.

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