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Query: UMLS:C0085437 (bacterial meningitis)
 4,038 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Modern cephalosporins are by now well established therapeutic drugs in the treatment of bacterial meningitis. Particularly for gram-negative meningitis they are valuable therapeutic tools. In most cases, they are very efficient and less toxic than former therapeutic regimens. Of course, they cannot replace penicillin G in the therapy of meningitis with penicillin-sensitive bacteria. The advantages and disadvantages of the single compounds, cefotaxime, latamoxef, ceftizoxime, cefmenoxime, ceftazidime, ceftriaxone and cefsulodin have to be evaluated. For safety reasons, monotherapy with these drugs is not recommended because there have been reports of failures and relapses of meningitis even in cases with highly sensitive organisms. They are almost or completely ineffective against a few pathogens in meningitis, such as anaerobes or Listeria monocytogenes. An attempt has been made to evaluate the different compounds for their therapeutic usefulness against different pathogens in meningitis.
Infection 1987
PMID:[Rational parameters in the treatment of bacterial meningitis with modern cephalosporins]. 331 38

The use of artificial ventilation in patients with bacterial meningitis was increased from 8.0% of 176 patients admitted in 1966-1968 to 31.5% of 162 patients admitted in 1975-1976. The therapeutic regimen was otherwise unchanged. The fatality rate decreased from 14.2% in the first period to 8.6% in the second, whereas the rate of neurological sequelae increased from 11.3% to 16.9%. A linear logistic model analysis was applied to correct for the influence of factors of known prognostic importance in the two periods, e. g. age, level of consciousness at admission, mode of admission and etiology. The analysis showed a significant 50% reduction in fatality rate (p = 0.05), whereas the corrected rate of neurological sequelae appeared similar in the two periods. Our results suggest that an increased use of respirator treatment may improve the prognosis in bacterial meningitis.
Infection
PMID:Artificial ventilation and prognostic factors in bacterial meningitis. 340 34

Ofloxacin diffusion into cerebrospinal fluid (CSF) was evaluated in nine patients with bacterial meningitis. Patients were under treatment with i.v. amoxicillin (100 mg/kg/day), and during the first five days they were also given oral ofloxacin, 200 mg b.i.d. On days 2 and 5, blood and CSF samples were collected for assays by both HPLC and microbiological techniques. Samples were obtained 2 h (n = 2), 4 h (n = 1), 6 h (n = 2), 8 h (n = 2) and 12 h (n = 2) after the ofloxacin dose respectively. Concentration in CSF was 50 to 60% of that in serum and there was no significant difference between results with the two assay techniques.
Infection 1986
PMID:Diffusion of ofloxacin into the cerebrospinal fluid in patients with bacterial meningitis. 346 56

In a prospective, clinical study forty-four children with bacterial meningitis were treated with antibiotics and underwent a special intravenous treatment with 7-S-immunoglobulins. The children's age ranged between two days and thirteen years. Two of the children died. The other forty-two children did not show any signs of neurological deficiencies upon release from the hospital. The apparently improved prognosis, due to the immunoglobulin therapy, was confirmed by a retrospective study of thirty-six patients, that had an unfavorable prognosis of pneumococcal meningitis. All fourteen patients that had acquired pneumococcal meningitis, and had been treated with immunoglobulins, were clinically cured, whereas in comparison, the sixteen patients of the other group exhibited severe sequelae, and two of them died.
Infection
PMID:[Immunoglobulins in the treatment of bacterial meningitis in childhood]. 355 8

Nine hundred seventy cases of childhood bacterial meningitis treated at 107 institutions in Japan from 1979 through 1984 were studied using questionnaire. The number of cases that underwent antimicrobial monotherapy remained nearly constant during the study period, but cases of therapies with beta-lactam combined with aminoglycosides (AGs) decreased in number and a gradual increase in the use of beta-lactam combined with non-AGs antibiotics including beta-lactam (Non AGs) was observed. A trend showing decrease in case fatality rate (CFR) was observed except that CFR for Gram-positive bacterial infections treated with beta-lactam + AGs remained at a same level. Cases treated with antibiotics were classified into 3 groups according to major etiological pathogens. Cases with Staphylococcus aureus gave a poor prognosis, among 27 total cases, CFR was 28.6% (2/7) with monotherapy, 50.0% (6/12) with beta-lactam + AGs and 37.5% (3/8) with beta-lactam + Non AGs (P less than 0.1). Among 100 cases of group B Streptococcus (GBS), CFR was 20.0% as a whole, 17.3% (9/52) for monotherapy and 34.5% (10/29) for beta-lactam + AGs (P less than 0.1). Among 198 cases of Streptococcus pneumoniae, CFR was 12.1% as a whole, and was 12.3% (18/146) with monotherapy. CFR for the cases treated with beta-lactam + AGs was 20.8% (5/24) and with beta-lactam + Non AGs was 3.6% (1/28) (P less than 0.1). CFR for 292 cases of Haemophilus influenzae meningitis was fairly low, and was 6.1% (9/148) with monotherapy, 7.4% (5/68) with beta-lactam + AGs and 3.9% (3/76) with beta-lactam + Non AGs, thus very slight differences were observed among the 3 groups of treatment. Among 111 cases of Escherichia coli, monotherapy and beta-lactam + Non AGs gave 6.5% (2/31) CFR, and 5.6% (1/18) CFR, respectively, whereas beta-lactam + AGs showed CFR of 19.4% (12/62), demonstrating a significant difference tendency (P less than 0.1). Similar tendencies were observed in the cases of Listeria monocytogenes, Proteus mirabilis, Pseudomonas aeruginosa and Enterococcus faecalis. Contrary to the high CFR observed with the beta-lactam + AGs treatment, significantly low CFR was frequently obtained in cases treated with a combination of penicillins with cephalosporins including latamoxef or beta-lactam with chloramphenicol. Infections with GBS, E. coli, and P. mirabilis occurred largely in the age between 0 to 6 months and CFR was especially high in the very young.(ABSTRACT TRUNCATED AT 400 WORDS)
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PMID:[Recent trend of childhood bacterial meningitis in Japan (1979-1984). Part 4. A classification of prognosis and antibiotic treatment based on causative agents]. 361 93

During the years 1966-1976, 875 patients were treated for bacterial meningitis at the University Clinic for Infectious Diseases, Copenhagen. By about January 1, 1980, all 782 surviving patients had been traced. 87 had died in the observation period of four to 15 years. Mortality in the years following meningitis was studied by means of a comparison with the expected mortality in a matched normal population, using a computer program for the determination of late excess mortality. Late excess mortality was significantly increased during the first two years following discharge after meningitis and was of the same magnitude in the major etiological groups. The cumulative five-year late excess mortality rate was higher in the group of patients between 30 and 60 years, in those transferred from other hospitals, in those in coma or somnolence on admission and in those developing convulsions during hospitalization. In the group of patients aged 30 to 60 years, 11 patients died during the first two years after discharge. In nine of these cases, the main cause or the concomitant causes of death were conditions predisposing to infections or bacterial meningitis. The frequency of the causes of death in the 87 patients who died was not significantly different from that among the general Danish population.
Infection
PMID:Mortality in the years following bacterial meningitis. 371 May 93

The purpose of this study was to evaluate the therapeutic effect of cefotaxime (CTX) and fosfomycin (FOS), alone or in combination, in an experimental meningitis, with cerebrospinal fluid (CSF) concentrations of the two antibiotics reproducing those obtained in human CSF during bacterial meningitis. With a dose of 50 mg/kg of CTX and 100 mg/kg of FOS injected i.v. (CTX over 0.5 h and FOS over 3 h), CSF concentrations were comparable to those observed in man. In a series of five rabbits per treatment group, the bacterial population was counted before and after treatment (two doses with a six-hour interval) with CTX, FOS or CTX + FOS (CTX over 0.5 h before the end of FOS infusion). By the 12th hour of treatment, the percentage of bacteria surviving in CSF compared to the initial population was 4.35% for CTX, 0.20% for FOS and 0.19% for CTX + FOS. Thus, it seemed that CTX + FOS was not more active than FOS alone. In another series of four rabbits per group, the bactericidal effect was followed at T0, T6, T12, T24 and T48 after treatment (two doses with a six-hour with a six-hour interval). With CTX, a variable drop in bacterial count from one rabbit to the other occurred during the first 12 h, and then a bacteriostasis followed. With FOS, a quick bactericidal effect was observed during the first 12 h, becoming slower during the following 36 h (0.03% of bacteria surviving at the 48th hour). With CTX and FOS in combination, a quick bactericidal effect was achieved, remaining steady over a 48-hour period (0.001% of bacteria surviving at the 48th hour).
Infection 1985
PMID:Bactericidal activity of cefotaxime and fosfomycin in cerebrospinal fluid during the treatment of rabbit meningitis experimentally induced by methicillin-resistant Staphylococcus aureus. 385 Aug 55

Information on 62 bacteriologically confirmed cases of bacterial meningitis treated with cefotaxime in this country was obtained retrospectively from infectious disease consultants. This series of cases differed markedly from the world cumulative case data so far presented. One of the two most common organisms treated was the pneumococcus (allergy to penicillin or misdiagnosis of the Gram stain were the major reasons given). Unanticipated bacteriologic successes were noted in two cases of staphylococcal meningitis secondary to parameningeal foci. The bacteriologic cure rate and survival rate were about 85%. Failure of monotherapy was seen in one case of pseudomonas meningitis, as well as in three of five cases of enterobacter meningitis. In addition, two cases of Escherichia coli meningitis which had inexplicably failed on moxalactam were cured with cefotaxime. Thus, overall not all gram-negative species and not all isolates of any particular species which cause meningitis can be successfully treated by cephalosporins. Data obtained during the investigative trials do not appear to be entirely predicative of what occurred during the free clinical use of an antibiotic. There is a need for the post-investigatory follow-up and surveillance of all newly introduced therapeutic agents.
Infection 1985
PMID:Cefotaxime in the treatment of meningitis. 405 58

The successful development and implementation of rational strategies for the prevention of bacterial meningitis should be facilitated by acquiring a more detailed knowledge of its pathophysiology. We have used a biologically relevant rat model of meningitis in conjunction with classical microbial genetics and recombinant DNA technology to investigate the molecular basis of Haemophilus influenzae pathogenicity. These studies aim to define how specific bacterial genes mediate the potential of H. influenzae to colonize the nasopharynx, disseminate within the blood stream and invade the central nervous system. By identifying the state or stages in the pathogenic sequence for which the determinant is critical, this approach should also provide insight into the relevant host defense mechanisms which determine resistance or susceptibility. An understanding of the genetic basis of H. influenzae pathogenicity may develop basic knowledge relevant to the treatment and prevention of bacterial meningitis.
Infection 1984
PMID:Pathogenesis of meningitis: experimental studies on the molecular basis of Haemophilus influenzae infection. 624 9

The epidemiological behaviour of bacterial meningitis is examined to find clues as to the determinants of the disease. Such an examination has shown that a very limited number of bacteria are able to cause the disease and has suggested some of the virulence characteristics thereof, most notably the presence of certain types of polysaccharide capsules, the predilection of the disease to the first years of life is partially explained by the gradual development of immunity, especially serum antibodies to the capsular polysaccharides. The varying proportion of asymptomatic carriers to those falling ill and the homogeneity of the bacteria in an epidemic speak for the existence of other, as yet unknown virulence factors.
Infection 1984
PMID:Functional epidemiology of bacterial meningitis. 639 48


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