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

Penetration of the aminoglycoside, amikacin, into the cerebrospinal fluid (CSF) of twenty children with acute bacterial meningitis was studied at various times after intramuscular administration and at various stages of therapy. Six of the patients were evaluated during therapy with amikacin at 7.5 mg/kg (intramuscularly) every 12 hours plus ampicillin every 6 hours at 300 mg/kg/day (intravenously); thirteen of the remaining fourteen patients were treated with ampicillin alone, but were given a single intramuscular dose of 7.5 mg/kg of amikacin for evaluation of CSF concentration. Amikacin concentration in CSF with respect to time after administration followed essentially the same pattern as in serum. A minimum concentration of 2 microgram/ml was found in 76% of the CSF samples obtained between 0.5 and 7 hours after administration. A mean amikacin serum/CSF ratio of 3:1 was demonstrated up to 7 hours after dose in all patients who underwent clinical improvement. Patient response was predictable by a correlation of in vitro MIC values with in vivo CSF concentration in three of the six patients who received amikacin therapy.
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PMID:Amikacin concentration in the cerebrospinal fluid of children with acute bacterial meningitis. 42 64

The penetration of amikacin into the cerebrospinal fluid (CSF) was studied with 16 children (mean age, 1 year and 9 months; range, 4 months to 8 years) with community-acquired bacterial meningitis. Amikacin was given intravenously at a dose of 7.5 mg/kg of body weight twice daily. CSF was collected on day 1, at the expected peak concentration of amikacin in CSF. The mean (standard deviation) concentration of amikacin in CSF was 1.65 (1.6) mg/liter. Concentrations of amikacin in CSF correlated significantly with CSF glucose levels on admission. The mean concentrations of amikacin in CSF were 2.9, 1.1, and 0.20 mg/liter in patients with CSF glucose levels of < 1, 1 to 2, and > 2 mmol/liter, respectively. Thus, amikacin penetrates the blood-brain barrier substantially in children with bacterial meningitis and achieves particularly high concentrations when CSF glucose level is < 1 mmol/liter on admission.
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PMID:Cerebrospinal fluid penetration of amikacin in children with community-acquired bacterial meningitis. 769 18

Third generation cephalosporin as cefotaxime or ceftriaxone is the best first line treatment. Duration of treatment is 7 to 10 days in uncomplicated disease. Dexamethasone used very early--before or at the same time of the antibiotic injection--seems to decrease sensorial sequelae. Amikacin by IV route, decreases short term complications. For bacterial meningitis due to intermediate penicillin pneumococci, an increase in daily dose of beta-lactamin is recommended; for resistant pneumococci, vancomycin by continuous infusion and with large doses is used. Chemoprophylaxis by rifampicine is effective for both Meningococcus and Haemophilus. Haemophilus influenzae b vaccination will decrease systemic infection due to this pathogen. In newborns, morbidity is higher, due in part to brain abscesses. Therapeutic choice is not the same for materno-foetal and postnatal infection. Antibiotherapy duration is, at least, 15 days and 21 days for gram-negative bacteria.
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PMID:[Treatment of bacterial meningitis in newborn infants and children]. 798 14