Materiały źródłowe

• #1 Meningitis – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/meningitis/diagnosis-treatment/drc-20350514

  Treatment depends on the type of meningitis. […] New-onset bacterial meningitis needs treatment right away with antibiotics given through a vein, called intravenous antibiotics. Sometimes corticosteroids are part of the treatment. This helps you recover and cuts the risk of complications, such as brain swelling and seizures. […] The antibiotic or mix of antibiotics depends on the type of germ causing the infection. Until your healthcare professional knows the exact cause of the meningitis, you may get a broad-spectrum antibiotic that fights a range of germs. […] Your healthcare professional may prescribe corticosteroids to reduce swelling in the brain and a medicine to control seizures. If a herpes virus caused your meningitis, you may get an antiviral medicine. […] Antibiotics can’t cure viral meningitis. Viral meningitis tends to get better in a few weeks. Treatment of mild viral meningitis includes: Bed rest. Plenty of fluids. Pain medicine to help reduce fever and relieve body aches.

• #1

  https://www.nhs.uk/conditions/meningitis/treatment/

  People with suspected meningitis will usually need to have tests in hospital and may need to stay in hospital for treatment. […] As bacterial meningitis can be very serious, treatment with antibiotics will usually start before the diagnosis is confirmed and will be stopped later on if tests show the condition is being caused by a virus. […] Treatment in hospital is recommended in all cases of bacterial meningitis, as the condition can cause serious problems and requires close monitoring. […] Severe viral meningitis may also be treated in hospital. […] Treatments include: antibiotics given directly into a vein, fluids given directly into a vein to prevent dehydration, oxygen through a face mask if there are any breathing difficulties, steroid medication to help reduce any swelling around the brain, in some cases.

• #1 Initial therapy and prognosis of community-acquired bacterial meningitis in adults – UpToDate

  https://www.uptodate.com/contents/initial-therapy-and-prognosis-of-community-acquired-bacterial-meningitis-in-adults

  Initial therapy and prognosis of community-acquired bacterial meningitis in adults […] Bacterial meningitis is a medical emergency, and immediate steps must be taken to establish the specific cause and initiate effective therapy. The mortality rate of untreated disease approaches 100 percent, and even with optimal therapy, it is associated with significant morbidity and mortality. […] The initial therapy and prognosis of community-acquired bacterial meningitis will be reviewed here. […] The management of health care-associated meningitis and ventriculitis is discussed in detail elsewhere. […] If possible, the following historical information should be obtained before antimicrobial therapy of presumed bacterial meningitis is instituted. […] Recommendations for empiric antimicrobial therapy for purulent meningitis based on patient age and specific predisposing condition. […] Recommendations for specific antimicrobial therapy of bacterial meningitis in adults based on isolated pathogen and susceptibility testing.

• #1 Meningitis Treatment & Management: Approach Considerations, Treatment of Subacute Meningitis, Treatment of Bacterial Meningitis

  https://emedicine.medscape.com/article/232915-treatment

  Frequently prescribed antibiotic treatments usually consist of third-generation cephalosporins for S pneumoniae and N meningitidis, ampicillin for L monocytogenes, and vancomycin for penicillin-resistant strains of S pneumoniae and S aureus. […] If patients show signs of illness and acute meningitis is suspected, initiate treatment with antibiotics and corticosteroids immediately after blood cultures are obtained, and continue to treat for bacterial meningitis is ruled out. […] In acute meningitis, regardless of presentation, a lumbar puncture (LP) and cerebrospinal fluid (CSF) examination are indicated to identify the causative organism and, in bacterial meningitis, the antibiotic sensitivities. […] The performance of radiographic imaging should not delay the initiation of empiric antimicrobial therapy; such therapy should be initiated before head CT if indicated. It is vital to begin treatment as early as possible in the disease course; delay may contribute significantly to morbidity and mortality.

• #1 Meningitis – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK459360/

  Antibiotics and supportive care are critical in all cases of bacterial meningitis. […] Managing the airway, maintaining oxygenation, giving sufficient intravenous fluids while providing fever control are parts of the foundation of meningitis management. […] The type of antibiotic is based on the presumed organism causing the infection. The clinician must take into account patient demographics and past medical history in order to provide the best antimicrobial coverage. […] Current Empiric Therapy includes Ampicillin and Cefotaxime for neonates, and Ceftriaxone and Vancomycin for adults. […] There is insufficient evidence to support the widespread use of steroids in bacterial meningitis. […] If the patient develops clinical signs of increased intracranial pressure, interventions to maintain cerebral perfusion include elevating the head of the bed and using osmotic diuretics. […] Chemoprophylaxis is indicated for close contacts of a patient diagnosed with N. meningitidis and H. influenzae type B meningitis.

• #1 Meningitis Treatment & Management: Approach Considerations, Treatment of Subacute Meningitis, Treatment of Bacterial Meningitis

  https://emedicine.medscape.com/article/232915-treatment

  In acutely ill patients, antibiotic therapy should be initiated promptly; in many of these cases, one should strongly consider giving adjunctive dexamethasone before the first antibiotic dose, or at least concomitantly with the dose. […] Appropriate antibiotic treatment for the most common types of bacterial meningitis reduces the risk of death. […] The chosen antibiotic should attain adequate levels in the CSF, and its ability to do so usually depends on its lipid solubility, molecular size, and protein-binding capacity, as well as on the patients degree of meningeal inflammation. […] Monitoring for possible drug toxicity during treatment (eg, with blood counts and renal and liver function monitoring) is warranted. […] The use of corticosteroids (typically, dexamethasone, 0.15 mg/kg every 6 hours for 2-4 days) as adjunctive treatment for bacterial meningitis improves outcome by attenuating the detrimental effects of host defenses (eg, inflammatory response to the bacterial products and the products of neutrophil activation).

• #1 Treatment and Prevention of Community-Acquired Bacterial Meningitis

  https://www.uspharmacist.com/article/treatment-and-prevention-of-communityacquired-bacterial-meningitis

  Bacterial meningitis is a serious infection that requires immediate treatment. Recommended empiric antimicrobial therapy is based upon the most likely pathogen, according to a patients age and immune status. Antimicrobial therapy should be modified after identification of the causative microorganism and results of susceptibility tests. […] If the LP is delayed for any reason including the need for additional diagnostic testing, such as a CT scan of the head empiric antimicrobial therapy should be started as soon as possible, ideally after blood cultures have been performed. It is important to start antimicrobial therapy even if the evaluation for bacterial meningitis is ongoing, since a delay in treatment is associated with increased morbidity and mortality. […] Once the causative microorganism has been identified and the results of susceptibility tests are known, antimicrobial therapy should be modified as indicated in Table 2.

• #1 Bacterial meningitis | MSF Medical Guidelines

  https://medicalguidelines.msf.org/en/viewport/CG/english/bacterial-meningitis-16689907.html

  Meningitis is an acute bacterial infection of the meninges, which may affect the brain and lead to irreversible neurological damage and auditory impairment. Bacterial meningitis is a medical emergency. The treatment is based on early parenteral administration of antibiotics that penetrates well into the cerebrospinal fluid (CSF). Empiric antibiotic therapy is administered if the pathogen cannot be identified or while waiting for laboratory results. […] For the choice of antibiotic therapy and dosages according to age, see table below. […] Duration of antibiotherapy: 1) According to the pathogen: Haemophilus influenzae: 7 days, Streptococcus pneumonia: 10-14 days, Group B streptococcus and Listeria: 14-21 days, Gram-negative bacilli: 21 days, Neisseria meningitidis: see antibiotherapy in an epidemic context.

• #1 Meningitis Treatment & Management: Approach Considerations, Treatment of Subacute Meningitis, Treatment of Bacterial Meningitis

  https://emedicine.medscape.com/article/232915-treatment

  The use of steroids has been shown to improve the overall outcome of patients with certain types of bacterial meningitis, including H influenzae, tuberculous, and pneumococcal meningitis. […] In developing countries, the use of oral glycerol (rather than dexamethasone) has been studied as adjunctive therapy in the treatment of bacterial meningitis in children. […] Intrathecal administration of antibiotics can be considered in patients with nosocomial meningitis (eg, meningitis developing after neurosurgery or placement of an external ventricular catheter) that does not respond to IV antibiotics. […] In cases where patients present with severe symptoms, prompt initiation of appropriate antibiotics and corticosteroids is recommended, regardless of test results, and continued until acute bacterial meningitis is definitively excluded through sterile cerebrospinal fluid (CSF) cultures. […] The treatment of choice for neurosyphilis is aqueous crystalline penicillin G (2-4 million U/day IV every 4 hours for 10-14 days), often followed with IM penicillin G benzathine (2.4 million U).

• #1 Meningococcal Meningitis: Symptoms, Causes, Treatments

  https://www.webmd.com/children/meningococcal-meningitis-symptoms-causes-treatments-and-vaccines

  The treatment for meningococcal meningitis is antibiotics, such as penicillin or ceftriaxone, given through an IV, usually for 5-7 days. Doctors sometimes also prescribe steroids and other medicines to control brain swelling. […] You or your child may need other emergency care to treat problems related to the infection, like low blood pressure. This can include: IV fluids, medications to raise your blood pressure, breathing support. […] Depending on how sick you are, you may need intensive care and have to spend a week or more in the hospital. […] If you or someone you love has come in close contact (through saliva or other oral secretions) with someone who has meningococcal meningitis such as at school, day care, work, or home it’s very important to get antibiotics to prevent infection.

• #1 Treatment of meningitis | Meningitis Now

  https://www.meningitisnow.org/meningitis-explained/meningitis-treatment/meningitis-treatment/

  Bacterial meningitis needs urgent treatment with intravenous antibiotics and rapid admission to hospital. […] Other treatment may include intravenous fluids (fluids given via a drip to prevent dehydration), painkillers and anti-sickness medication. […] In some cases, steroid medication may be given to help reduce swelling around the brain. […] Some people will become very ill and will require specialist care and treatment in an intensive care unit. […] There is no specific treatment for most cases of viral meningitis. […] Antibiotics are not effective against viruses although, in some instances, antibiotics may be started on admission to hospital because the cause of meningitis is unknown. […] Once doctors have confirmed viral meningitis and the persons condition is stable, they may discharge the patient from hospital to continue their recovery at home. […] Patients need to be hydrated with fluids, given painkillers and allowed to rest in order to recover.

• #1 Meningitis: Causes, Symptoms, Diagnosis & Treatment

  https://my.clevelandclinic.org/health/diseases/14600-meningitis

  Meningitis treatment depends on the cause. Antibiotics are used to treat bacterial meningitis and antifungals are used to treat fungal meningitis. Antivirals can be used to treat some viral causes of meningitis. Non-infectious causes of meningitis are treated by addressing the underlying illness or injury. […] There are no specific treatments for other infectious causes of meningitis. Medications might be used to reduce inflammation or relieve your symptoms. […] Medications and other therapies that might be used to treat meningitis include: Antibiotics for bacterial meningitis. Antifungals for fungal meningitis. Antivirals for certain cases of viral meningitis, like herpesvirus and influenza. Corticosteroids, like dexamethasone or prednisone, to reduce inflammation. Pain relievers. IV fluids to keep you hydrated. […] You may start to feel better within a few days to a week after starting treatment for meningitis. Full recovery can take weeks to months.

• #1 Management of acute meningitis

  https://pmc.ncbi.nlm.nih.gov/articles/PMC6303447/

  Acute meningitis remains a devastating disease. Clinicians need a low threshold for suspecting meningitis, to undertake appropriate investigations and provide treatment in a timely manner, to minimise the risk of poor outcome in bacterial disease, while limiting unnecessary treatment in viral meningitis. […] Treatment for bacterial meningitis is antibiotics, with or without steroids. The choice of antibiotics is a three stage process: an initial empirical decision based on clinical suspicion, review following microscopy results, and review again when culture or PCR results are available. […] In suspected bacterial meningitis, dexamethasone should be started either shortly before or simultaneously with antibiotics at 10 mg intravenously (IV) 6-hourly. […] There is no specific treatment for viral meningitis. Treatment with aciclovir has only been of proven benefit in herpes encephalitis, not meningitis. Only if the patient has encephalitic features, such as impairment of consciousness, focal neurological signs, inflammation of brain parenchyma in the region of the temporal lobe on cranial imaging, should aciclovir be considered.

• #1

  https://www.nhs.uk/conditions/meningitis/treatment/

  People with meningitis may need to stay in hospital for a few days, and in certain cases treatment may be needed for several weeks. […] Additional treatment and long-term support may also be required if any complications of meningitis occur, such as hearing loss. […] You’ll usually be able to go home from hospital if you or your child has mild meningitis and tests show it’s being caused by a viral infection. […] This type of meningitis will usually get better on its own without causing any serious problems. Most people feel better within 7 to 10 days. […] If you feel unable to manage your symptoms at home or you feel worse, get further medical help.

• #1 Meningitis – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/meningitis/diagnosis-treatment/drc-20350514

  If the cause of your meningitis is not known, you may need to wait to start antibiotic treatment until your healthcare professional finds the cause. […] Treatment for ongoing meningitis, called chronic meningitis, depends on the cause. […] Antifungal medicines treat fungal meningitis. A mix of antibiotics can treat tuberculous meningitis. But these medicines can have serious side effects. So you might wait for treatment until a lab confirms that the cause is fungal or tuberculous. […] Corticosteroids may treat meningitis due to allergic reaction or autoimmune disease. Sometimes, you don’t need treatment because the condition clears up on its own. Cancer-related meningitis needs treatment for the cancer.

• #1 Meningitis in Children | Boston Children’s Hospital

  https://www.childrenshospital.org/conditions/meningitis

  Antibiotics can start before the results of the lumbar puncture are available. […] A corticosteroid, or steroid, such as dexamethasone can decrease inflammation and reduce pressure that can build up in the brain. […] With the exception of the herpes simplex virus, there are no medications to treat the organisms that cause viral meningitis. […] Most children with viral meningitis recover on their own without treatment. […] Anti-fungal intravenous (IV) medication. […] A long course (one year) of medications. […] Usually involves several different medications for the first few months, followed by other medications. […] Boston Childrens is constantly working to prevent, identify and treat meningitis is a more effective way.

• #1 Symptoms, transmission, and current treatments for cryptococcal meningitis | DNDi

  https://dndi.org/diseases/cryptococcal-meningitis/facts/

  Cryptococcal meningitis is a fungal infection caused by Cryptococcus neoformans, which is often found in bird droppings. […] Antiretroviral therapy helps improve the immune systems of HIV patients, reducing the risk of cryptococcal meningitis, but the infection remains a serious problem in areas where HIV is very common. […] Cryptococcal meningitis can be treated effectively with a combination of drugs, but one of the key drugs (flucytosine) is unregistered in most African countries, and availability is very limited. […] The World Health Organization recommends that cryptococcal meningitis is treated with: 1 mg/kg/day amphotericin B and 100 mg/kg/day flucytosine divided into four doses per day for one week, followed by fluconazole at 1200 mg/day for one week, followed by fluconazole at 800 mg/day for eight weeks, followed by, finally, fluconazole at 200 mg/day for at least a year.

• #1 Diagnosis, Initial Management, and Prevention of Meningitis | AAFP

  https://www.aafp.org/pubs/afp/issues/2010/1215/p1491.html

  After the results of the Gram stain, culture, and susceptibility tests are available, specific therapy targeting the pathogen should be administered. […] Polymerase chain reaction testing of CSF is more sensitive than CSF culture, particularly in patients who received previous antimicrobials. […] Initial treatment is a combination of isoniazid, rifampin, pyrazinamide, and ethambutol. […] Adding dexamethasone to the treatment regimen improves mortality in patients older than 14 years with tuberculous meningitis. […] Initial treatment includes amphotericin B plus flucytosine.

• #1 Antibiotics for meningitis: Examples and effectiveness

  https://www.medicalnewstoday.com/articles/antibiotics-for-meningitis

  A doctor will usually prescribe intravenous penicillin in doses given every 4 hours for 10-14 days. […] A doctor may prescribe the antibiotic doxycycline for facial palsy due to Lyme disease. For Lyme meningitis, they may also use doxycycline or, alternately, ceftriaxone. […] Antibiotics treat a variety of conditions, including bacterial meningitis. […] People can also treat some other forms of meningitis, such as syphilitic and Lyme meningitis, with antibiotics.

• #1 Meningococcal Meningitis Treatment & Management: Approach Considerations, Pharmacologic Care, Prophylaxis

  https://emedicine.medscape.com/article/1165557-treatment

  Antimicrobials commonly used for chemoprophylaxis are rifampin, ciprofloxacin, ceftriaxone, minocycline, and spiramycin. […] Ceftriaxone may provide an effective alternative to rifampin for prophylaxis in people in close contact with patients with meningococcal meningitis. […] Complete appropriate antimicrobial therapy course. Observe the patient for any complications or neurological sequelae. […] Advise any household contacts and close respiratory contacts that chemoprophylaxis agents are available to eliminate the carrier state and prevent the spread of infection.

• #1 Treatment of bacterial meningitis following admission to secondary care (Antimicrobial) | Right Decisions

  https://rightdecisions.scot.nhs.uk/tam-treatments-and-medicines-nhs-highland/adult-therapeutic-guidelines/antimicrobial-guidance/meningitis-antimicrobial/treatment-of-bacterial-meningitis-following-admission-to-secondary-care-antimicrobial/

  ADD IV aciclovir 10mg/kg every 8 hours. […] Usually self limiting and does not require treatment with aciclovir or antibiotics. […] Adult: IV or IM benzylpenicillin 24g every 4 hours Child: IV or IM benzylpenicillin 50mg/kg every 4 hours. […] Adult: IV ceftriaxone 2g twice daily for 10 days Child: IV ceftriaxone as per BNFC once daily. […] Seek immediate advice from Public Health/ Health Protection Team. […] Patients treated solely with benzylpenicillin or cefotaxime require a single dose of oral ciprofloxacin to eradicate nasal carriage.

• #1 Meningitis in Kids (for Parents) | Nemours KidsHealth

  https://kidshealth.org/en/parents/meningitis.html

  Bacterial meningitis can cause serious problems that might need extra treatment, possibly in the hospital ICU. Someone with very low blood pressure might get more IV fluids and medicines to increase blood pressure. Someone might need extra oxygen or mechanical ventilation (breathing machine) if they have trouble breathing. […] Problems from bacterial meningitis can be severe and include neurological problems, such as hearing loss, vision problems, seizures, and learning disabilities. Anyone who has had bacterial meningitis should get a hearing test after they recover.

• #1 Recovering from meningitis | Meningitis Now

  https://www.meningitisnow.org/meningitis-explained/after-effects-meningitis/recovering-from-meningitis/

  Everyone leaving hospital after meningitis should be given information about recovery and what to expect, as well as being made aware of the support available. […] Anyone who has been left with ongoing problems following meningitis should be given a plan for future treatment and care, as well as being made aware of what support is available. […] Anyone who has been diagnosed with bacterial meningitis, should be offered a follow-up medical appointment. For adults, this should be within six weeks after discharge. […] The follow up appointment provides an opportunity to discuss the recovery process and any complications causing concern. […] Anyone who has been discharged following viral meningitis and has not been offered a follow up medical appointment, should contact their GP if they have any concerns regarding their recovery.

• #1 Meningitis and encephalitis

  https://www.rch.org.au/clinicalguide/guideline_index/Meningitis_encephalitis/

  All children with encephalitis or bacterial meningitis should have formal audiology assessment 6-8 weeks after discharge (earlier if concerns) […] Consider consultation with local paediatric team […] Consider transfer when […] Children can complete IV treatment through HITH services if available once haemodynamically stable, afebrile and decision made regarding directed treatment.

• #1

  https://www.who.int/news-room/fact-sheets/detail/meningitis

  Meningitis is a medical emergency and requires urgent medical attention in an appropriate health-care facility. […] Antibiotic treatment should be started as soon as possible when bacterial meningitis is suspected. The first dose of antibiotic treatment should not be delayed until the results of the lumbar puncture are available. The choice of antibiotic treatment should consider the age of the patient, presence of immunosuppression, and local prevalence of antimicrobial resistance patterns. In non-epidemic settings, intravenous corticosteroids (e.g., dexamethasone) are initiated with the first dose of antibiotics to reduce the inflammatory response and the risk of neurological sequelae and death. […] Those who have lived through meningitis can have complications such as deafness, learning impairment or behavioural problem and require long-term treatment and care. The ongoing psychosocial impacts of disability from meningitis can have medical, educational, social and human rights-based implications. Access to both services and support for these conditions is often insufficient, especially in low- and middle-income countries.

• #1 Bacterial Meningitis: History of Diagnosis and Treatment

  https://asm.org/articles/2024/july/bacterial-meningitis-a-history-of-diagnosis-and-tr

  If meningitis is suspected or meningococcal disease is known to be present, health care providers will immediately administer antibiotics, sometimes even before a diagnosis is confirmed. […] The rapid progression of meningiococcal disease necessitates quick action, and the lifesaving potential of properly administered antibiotics supports such empirical therapy. […] The best way to prevent meningococcal disease is to get vaccinated. […] The CDC recommends meningococcal vaccination for all preteens and teens, as well children and adults at increased risk for meningococcal disease. […] There are currently 3 types of meningococcal vaccines available in the United States: Meningococcal conjugate or MenACWY vaccines (Menveo and MenQuadfi), Serogroup B meningococcal or MenB vaccines (Bexsero and Trumenba), Pentavalent meningococcal or MenABCWY vaccine (PenbrayaTM).

• #1 Acute Bacterial Meningitis – Brain, Spinal Cord, and Nerve Disorders – Merck Manual Consumer Version

  https://www.merckmanuals.com/home/brain-spinal-cord-and-nerve-disorders/meningitis/acute-bacterial-meningitis

  Shock: Additional fluids and sometimes medications (given intravenously) are given to increase blood pressure and treat shock, as may occur in Waterhouse-Friderichsen syndrome. […] Coma: Mechanical ventilation may need to be used. […] Dangerously increased pressure within the skull (intracranial hypertension): The head of the bed is elevated, and corticosteroids are used to reduce pressure within the skull. […] If treated early, most people with meningitis recover well. But when treatment is delayed, permanent brain or nerve damage or death is more likely, especially in very young children and people over 60. […] Vaccines for several forms of bacterial meningitis are available. […] A vaccine (meningococcal vaccine) can help prevent meningococcal meningitis. […] A vaccine that helps protect against this infection (pneumococcal vaccine) is routinely given to children and is recommended for older adults. […] Children are now routinely immunized with Haemophilus influenzae type b vaccine.

• #1 Meningitis – Management : Emergency Care BC

  https://emergencycarebc.ca/clinical_resource/clinical-summary/meningitis-management/

  Infections, Neurological […] 8 to 15% of patients with bacterial meningitis die within 48 hours of symptom onset even with early diagnosis and treatment. […] Initial Management: IV fluid resuscitation as you would for sepsis […] Management of acute cerebral edema or elevated intracranial pressure (ICP) (above 15 or 20 mm Hg): Endotracheal intubation and hyperventilation aiming for a PaCO2 of 35 mmHg. […] Administer empiric antimicrobial therapy, plus dexamethasone if suspecting bacterial meningitis, STAT. […] Do not delay the initiation of antimicrobial therapy, i.e. if LP is delayed, in a patient with suspected meningitis! […] Administer empiric antibiotics, plus dexamethasone if suspecting bacterial meningitis, immediately after LP. […] Shown to lower the rate of hearing loss and other neurologic complications, and mortality in some patients with bacterial meningitis due to pneumoniae.

• #1 Bacterial Meningitis: Symptoms, Causes & Treatment

  https://my.clevelandclinic.org/health/diseases/11039-bacterial-meningitis

  Bacterial meningitis is a very serious type of meningitis. If you have symptoms of bacterial meningitis, you should seek immediate treatment. Early diagnosis and treatment with antibiotics can often lead to a full recovery. […] Bacterial meningitis can cause death within hours. […] If you or your child has any of these symptoms, go to your nearest emergency room or call 911 right away. Bacterial meningitis can worsen quickly, leading to coma and even death within hours. […] If you suspect you have meningitis, it’s important that you seek immediate medical assistance. […] Healthcare providers treat bacterial meningitis with antibiotics. They’ll give you an IV (intravenous) antibiotic with a corticosteroid to bring down the inflammation even before all the test results are in. […] Early diagnosis and treatment with antibiotics lead to a better chance of recovery.

• #2 Meningitis Treatment & Management: Approach Considerations, Treatment of Subacute Meningitis, Treatment of Bacterial Meningitis

  https://emedicine.medscape.com/article/232915-treatment

  Frequently prescribed antibiotic treatments usually consist of third-generation cephalosporins for S pneumoniae and N meningitidis, ampicillin for L monocytogenes, and vancomycin for penicillin-resistant strains of S pneumoniae and S aureus. […] If patients show signs of illness and acute meningitis is suspected, initiate treatment with antibiotics and corticosteroids immediately after blood cultures are obtained, and continue to treat for bacterial meningitis is ruled out. […] In acute meningitis, regardless of presentation, a lumbar puncture (LP) and cerebrospinal fluid (CSF) examination are indicated to identify the causative organism and, in bacterial meningitis, the antibiotic sensitivities. […] The performance of radiographic imaging should not delay the initiation of empiric antimicrobial therapy; such therapy should be initiated before head CT if indicated. It is vital to begin treatment as early as possible in the disease course; delay may contribute significantly to morbidity and mortality.

• #2 Management of acute meningitis

  https://pmc.ncbi.nlm.nih.gov/articles/PMC6303447/

  Acute meningitis remains a devastating disease. Clinicians need a low threshold for suspecting meningitis, to undertake appropriate investigations and provide treatment in a timely manner, to minimise the risk of poor outcome in bacterial disease, while limiting unnecessary treatment in viral meningitis. […] Treatment for bacterial meningitis is antibiotics, with or without steroids. The choice of antibiotics is a three stage process: an initial empirical decision based on clinical suspicion, review following microscopy results, and review again when culture or PCR results are available. […] In suspected bacterial meningitis, dexamethasone should be started either shortly before or simultaneously with antibiotics at 10 mg intravenously (IV) 6-hourly. […] There is no specific treatment for viral meningitis. Treatment with aciclovir has only been of proven benefit in herpes encephalitis, not meningitis. Only if the patient has encephalitic features, such as impairment of consciousness, focal neurological signs, inflammation of brain parenchyma in the region of the temporal lobe on cranial imaging, should aciclovir be considered.

• #2 Meningitis – Knowledge @ AMBOSS

  https://www.amboss.com/us/knowledge/meningitis/

  Administer empiric antibiotics as soon as possible, preferably within 1 hour. […] If LP can be performed rapidly, administer antibiotics and adjuvant therapy (e.g., dexamethasone) after obtaining CSF. […] If LP is delayed (e.g., because neuroimaging is required), administer antibiotics and adjuvant therapy (e.g., dexamethasone) immediately. […] The choice of initial empiric therapy depends primarily on the prevalence of organisms in certain age groups and individual patient risk factors for resistant organisms. […] Most cases of viral meningitis (e.g., caused by enteroviruses) can be treated supportively. Specific antiviral therapy is only warranted if viral encephalitis is also suspected. […] Recommended empiric antiviral agent: acyclovir. […] Treatment with acyclovir should be started in all patients who present with typical clinical signs of viral meningoencephalitis and only discontinued after PCR and antibody tests are negative for HSV and VZV, even if CSF is initially normal.

• #2 Meningitis – UF Health

  https://ufhealth.org/conditions-and-treatments/meningitis

  Antibiotics are used to treat bacterial meningitis. Antibiotics do not treat viral meningitis. But antiviral medicine may be given to those with herpes meningitis. […] Early diagnosis and treatment of bacterial meningitis is essential to prevent permanent neurological damage. Viral meningitis is usually not serious, and symptoms should disappear within 2 weeks with no lasting complications. […] If you think that you or your child has symptoms of meningitis, get emergency medical help immediately. Early treatment is key to a good outcome.

• #2 Meningococcal Meningitis Treatment & Management: Approach Considerations, Pharmacologic Care, Prophylaxis

  https://emedicine.medscape.com/article/1165557-treatment

  Initial empirical therapy until the etiology is established should include dexamethasone, a third-generation cephalosporin (eg, ceftriaxone, cefotaxime), and vancomycin. […] Once an accurate diagnosis of meningococcal meningitis is established, appropriate changes can be made. Currently, a third-generation cephalosporin (ceftriaxone or cefotaxime) is the drug of choice for the treatment of meningococcal meningitis and septicemia. […] The use of dexamethasone in the management of bacterial meningitis in adults remains controversial. It may be used in children, especially in those with meningitis caused by Haemophilus influenzae. In adults with suspected bacterial meningitis, especially in high-risk cases, the adjunctive use of dexamethasone may be beneficial. […] Chemoprophylaxis can be considered for people in close contact with patients in an endemic situation.

• #2 Meningitis – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK459360/

  Antibiotics and supportive care are critical in all cases of bacterial meningitis. […] Managing the airway, maintaining oxygenation, giving sufficient intravenous fluids while providing fever control are parts of the foundation of meningitis management. […] The type of antibiotic is based on the presumed organism causing the infection. The clinician must take into account patient demographics and past medical history in order to provide the best antimicrobial coverage. […] Current Empiric Therapy includes Ampicillin and Cefotaxime for neonates, and Ceftriaxone and Vancomycin for adults. […] There is insufficient evidence to support the widespread use of steroids in bacterial meningitis. […] If the patient develops clinical signs of increased intracranial pressure, interventions to maintain cerebral perfusion include elevating the head of the bed and using osmotic diuretics. […] Chemoprophylaxis is indicated for close contacts of a patient diagnosed with N. meningitidis and H. influenzae type B meningitis.

• #2

• #2 Meningitis – Management : Emergency Care BC

  https://emergencycarebc.ca/clinical_resource/clinical-summary/meningitis-management/

  Adjunctive dexamethasone (0.15 mg/kg i.e.10 MG) IV q6H for four days) should be given 15-20 minutes before or at the same time as the first dose of antibiotics when bacterial meningitis is suspected. […] Recommended duration of treatment based on pathogenic bacterial species: Neisseria meningitidis: 7 days […] Streptococcus pneumoniae: 10 to 14 days […] Listeria monocytogenes: ≥ 21 days […] Haemophilus influenzae: 7 to 10 days.

• #2 Treatment and Prevention of Community-Acquired Bacterial Meningitis

  https://www.uspharmacist.com/article/treatment-and-prevention-of-communityacquired-bacterial-meningitis

  The rationale for use of adjunctive dexamethasone is to reduce the inflammatory response in the subarachnoid space (caused by the release of bacterial components from bactericidal therapy) that leads to inflammation-related neurological complications. Adjunctive dexamethasone has been shown to decrease mortality in adults with pneumococcal meningitis and to decrease hearing loss in children with meningitis caused by Haemophilus influenzae type b. […] Antimicrobial chemoprophylaxis is indicated in certain situations to prevent the spread of infection from those with meningitis caused by N meningitidis or H influenzae. […] Pharmacists play an integral role in the management of bacterial meningitis by working collaboratively with clinicians to select the most appropriate empiric and directed antimicrobial therapy regimen based on patient-specific factors. Pharmacists can recommend chemoprophylaxis when warranted and advocate for routine use of vaccinations for prevention of this serious infection.

• #2

  https://www.nhs.uk/conditions/meningitis/treatment/

  People with meningitis may need to stay in hospital for a few days, and in certain cases treatment may be needed for several weeks. […] Additional treatment and long-term support may also be required if any complications of meningitis occur, such as hearing loss. […] You’ll usually be able to go home from hospital if you or your child has mild meningitis and tests show it’s being caused by a viral infection. […] This type of meningitis will usually get better on its own without causing any serious problems. Most people feel better within 7 to 10 days. […] If you feel unable to manage your symptoms at home or you feel worse, get further medical help.

• #2 Meningitis: Symptoms, Causes, Types, Treatment, Risks, Vaccine

  https://www.healthline.com/health/meningitis

  Meningitis can occur due to a viral, bacterial, or fungal infection and requires emergency medical treatment. […] Treatment for meningitis depends on the cause. […] Bacterial meningitis requires immediate hospitalization. Early diagnosis and treatment with intravenous (IV) antibiotics and steroids may prevent brain damage and death. […] Fungal meningitis requires treatment with antifungal medication. […] Parasitic meningitis may either involve treating just symptoms or the infection directly. If it worsens, a doctor may try to treat the infection itself. […] Viral meningitis may resolve on its own, but doctors treat some causes with IV antiviral medications. […] Chronic meningitis requires treating the underlying cause, such as a fungal infection, or an autoimmune issue, such as rheumatoid arthritis.

• #2 Azthena logo with the word Azthena

  https://www.news-medical.net/health/Meningitis-Treatment.aspx

  General measures such as anti-emetics for the nausea and vomiting and anti-seizure medications or anticonvulsants for seizures are recommended. […] Usually a week or so of hospital stay is needed if the patient responds well to antibiotics. Those with more severe illness may need to stay in the hospital longer. […] Severe viral meningitis requires hospital admission. […] Treatment is begun with vital support with oxygen and intravenous fluids and antibiotics. […] Once diagnosis is made and causative virus identified, antibiotics are withdrawn since they are infective against viruses. However, intravenous fluids will be continued. […] Some severe infections may require antiviral medications. Aciclovir is considered beneficial in treating herpetic viral infections but only if given very early in the course of the infection. Patients need to be given Aciclovir injections immediately if there is suspicion of herpes encephalitis or brain infection. Ganciclovir is effective for cytomegalovirus (CMV) infections. […] Those with a mild viral meningitis will not require hospital treatment. These patients need bed rest, plenty of fluids and painkillers for headache and anti-emetics for nausea and vomiting. […] Recovery is usually within a week or two.

• #2 About Viral Meningitis | Meningitis | CDC

  https://www.cdc.gov/meningitis/about/viral-meningitis.html

  In most cases, there’s no specific treatment for viral meningitis. Most people with mild viral meningitis usually get better on their own within 7 to 10 days. […] People who develop severe illness, or are at risk for developing severe illness, may need hospital care. […] Antiviral medicine may help people with meningitis caused by viruses such as herpesvirus and influenza.

• #2 Meningitis Causes, Symptoms & Treatment | Baptist Health

  https://www.baptisthealth.com/care-services/conditions-treatments/meningitis

  Treatment, which in most cases requires hospitalization and possibly admission to the intensive care unit, may include: […] Intravenous (IV) antibiotics are the first line of treatment for bacterial meningitis necessary to ensure survival and reduce complications. The antibiotic or combination of antibiotics given depends on the bacteria causing the infection. […] These medications may be prescribed to control seizures during an active infection or as a result of meningitis complications. […] Rarely, meningitis can be caused by a fungal infection, rather than by bacteria or a virus. In this case, antifungals will be administered intravenously or by mouth. […] In the case of viral meningitis, most cases improve on their own after a couple of weeks. Bed rest is recommended as a patient recovers. Bed rest is also necessary after treatment for bacterial meningitis until a patient regains his/her strength.

• #2 Meningitis in Children – Stanford Medicine Children’s Health

  https://www.stanfordchildrens.org/en/topic/default?id=meningitis-in-children-90-P02528

  Fungal meningitis. Your child may get IV antifungal medicine. […] Tuberculous (TB) meningitis. Your child will be treated with a course of medicines over 1 year. Treatment is done with several medicines for the first few months. This is followed by other medicines for the remaining time. […] While your child is recovering from meningitis, he or she may also need: Bed rest, Increased fluid intake by mouth or IV fluids in the hospital, Medicines to reduce fever and headache. Don’t give aspirin or medicine that contains aspirin to a child younger than age 19 unless directed by your child’s provider. Taking aspirin can put your child at risk for Reye syndrome. This is a rare but very serious disorder. It most often affects the brain and the liver. […] Talk with your child’s healthcare providers about the risks, benefits, and possible side effects of all treatments.

• #2 Meningococcal Meningitis Treatment & Management: Approach Considerations, Pharmacologic Care, Prophylaxis

  https://emedicine.medscape.com/article/1165557-treatment

  Antimicrobials commonly used for chemoprophylaxis are rifampin, ciprofloxacin, ceftriaxone, minocycline, and spiramycin. […] Ceftriaxone may provide an effective alternative to rifampin for prophylaxis in people in close contact with patients with meningococcal meningitis. […] Complete appropriate antimicrobial therapy course. Observe the patient for any complications or neurological sequelae. […] Advise any household contacts and close respiratory contacts that chemoprophylaxis agents are available to eliminate the carrier state and prevent the spread of infection.

• #2 Clinical Guidance for Meningococcal Disease | Meningococcal | CDC

  https://www.cdc.gov/meningococcal/hcp/clinical-guidance/index.html

  Ceftriaxone clears nasopharyngeal carriage effectively after 1 dose. […] If ceftriaxone or cefotaxime aren’t used for treatment, one of the following is recommended before hospital discharge to eradicate nasopharyngeal carriage: A course of rifampin (4 doses over 2 days) or a single dose of ciprofloxacin or ceftriaxone.

• #2

  https://www.who.int/news-room/fact-sheets/detail/meningitis

  Meningitis is a medical emergency and requires urgent medical attention in an appropriate health-care facility. […] Antibiotic treatment should be started as soon as possible when bacterial meningitis is suspected. The first dose of antibiotic treatment should not be delayed until the results of the lumbar puncture are available. The choice of antibiotic treatment should consider the age of the patient, presence of immunosuppression, and local prevalence of antimicrobial resistance patterns. In non-epidemic settings, intravenous corticosteroids (e.g., dexamethasone) are initiated with the first dose of antibiotics to reduce the inflammatory response and the risk of neurological sequelae and death. […] Those who have lived through meningitis can have complications such as deafness, learning impairment or behavioural problem and require long-term treatment and care. The ongoing psychosocial impacts of disability from meningitis can have medical, educational, social and human rights-based implications. Access to both services and support for these conditions is often insufficient, especially in low- and middle-income countries.

• #2 Recovering from meningitis | Meningitis Now

  https://www.meningitisnow.org/meningitis-explained/after-effects-meningitis/recovering-from-meningitis/

  Most people will make a good recovery from meningitis. However for many, they recover from the acute phase of the illness only to find that whilst trying to get back to their everyday activities, they experience some difficulties. […] Persistent headaches, tiredness, memory problems, personality changes and depression are just some of the hidden after-effects people can experience. […] If you are concerned about your recovery or possible complications, speak to your GP, or ask to be referred back to the hospital where you received your care. […] Our free support services can help you rebuild your life after meningitis.

• #2

  https://www.meningitis.org/meningitis/bacterial-meningitis

  Doctors across many countries will follow clinical guidelines to treat patients with meningitis. These guidelines describe the best way to recognise, diagnose, treat and provide follow-up care for patients with meningitis in their country. […] The World Health Organization and UNICEF have designed the Integrated Management of Childhood Illness (IMCI) strategy which promotes accurate identification and appropriate treatment of serious illness in children under five. […] In some countries (including the UK) doctors will arrange at least one follow-up appointment so they can check for longer-term after-effects. This is particularly important for children, as some long-term neurodevelopmental complications can’t always be identified immediately after their illness. […] Yes, we can prevent the leading causes of bacterial meningitis. Vaccines are available that protect against meningococcal, pneumococcal, Haemophilus influenzae type B and Mycobacterium tuberculosis bacteria. Meningitis vaccines are freely available to people at the highest risk of illness in many countries across the world. […] Bacterial meningitis is treated with antibiotics, which will not work to treat viral meningitis. There are no specific treatments for viral meningitis. Instead, doctors will treat the symptoms of the disease as the body’s own immune system fights off the virus.

• #2 Acute Bacterial Meningitis – Brain, Spinal Cord, and Nerve Disorders – Merck Manual Consumer Version

  https://www.merckmanuals.com/home/brain-spinal-cord-and-nerve-disorders/meningitis/acute-bacterial-meningitis

  Shock: Additional fluids and sometimes medications (given intravenously) are given to increase blood pressure and treat shock, as may occur in Waterhouse-Friderichsen syndrome. […] Coma: Mechanical ventilation may need to be used. […] Dangerously increased pressure within the skull (intracranial hypertension): The head of the bed is elevated, and corticosteroids are used to reduce pressure within the skull. […] If treated early, most people with meningitis recover well. But when treatment is delayed, permanent brain or nerve damage or death is more likely, especially in very young children and people over 60. […] Vaccines for several forms of bacterial meningitis are available. […] A vaccine (meningococcal vaccine) can help prevent meningococcal meningitis. […] A vaccine that helps protect against this infection (pneumococcal vaccine) is routinely given to children and is recommended for older adults. […] Children are now routinely immunized with Haemophilus influenzae type b vaccine.

• #2

  https://www.who.int/health-topics/meningitis

  Meningitis is a medical emergency and requires urgent medical attention. Antibiotic treatment should be started as soon as possible when bacterial meningitis is suspected. The first dose of antibiotic treatment should not be delayed until the results of the lumbar puncture are available. […] In non-epidemic settings, intravenous corticosteroids are initiated with the first dose of antibiotics, in order to reduce the inflammatory response and the risk of neurological sequelae and death. […] If treatment is started prior to the lumbar puncture, it may be difficult to grow the bacteria from the spinal fluid and confirm the diagnosis. However, confirmation of the diagnosis should not delay treatment. […] Vaccines against meningococcal, pneumococcal and Haemophilus influenzae disease have been available for many years.

• #2 Bacterial Meningitis: Symptoms, Causes & Treatment

  https://my.clevelandclinic.org/health/diseases/11039-bacterial-meningitis

  Bacterial meningitis is a very serious, life-threatening disease. If you have symptoms of the condition, it’s important to seek medical attention right away. Early diagnosis and treatment with antibiotics can often lead to a full recovery. But delayed treatment can lead to long-term complications and even death.

• #3 Antibiotics for Meningitis: Types, Side Effects and More

  https://www.healthline.com/health/meningitis-antibiotics

  In addition to antibiotics, you might also receive the following through an IV during your bacterial meningitis treatment: a steroid to ease brain swelling, fluids to keep you hydrated, oxygen, if having trouble breathing. […] The corticosteroid dexamethasone has been found effective in treating bacterial meningitis when combined with antibiotics. […] Bacterial meningitis is a serious infection that requires hospitalization and treatment with antibiotics. Delaying treatment can increase the risk of dying or having serious long-term health complications. […] Youll receive antibiotics by IV, as well as other medications and fluids to reduce your symptoms. Treatment may last one to several weeks.

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