Gene/Protein Disease Symptom Drug Enzyme Compound
Pivot Concepts:   Target Concepts:
Query: UMLS:C0085437 (bacterial meningitis)
 4,038 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The use of antibiotics in viral diseases of childhood is discussed. If bacterial infection is likely, either as superinfection or as part of the differential diagnosis, then antibiotics should be given. The antibiotic of choice for each illness is considered. Respiratory infections are common. The diagnosis and treatment of streptococcal pharyngitis is compared with viral pharyngitis. Penicillin is indicated if the bacterial infection is possible. If there is difficulty in distinguishing between croup and epiglottitis, then chloramphenicol or ampicillin should be given. Otitis media and pneumonia caused by viruses are difficult to differentiate from their bacterial counterparts, and antibiotics are indicated. By contrast, antibiotics are not used in bronchiolitis or asthma. Antibiotics are contraindicated in gastroenteritis even if caused by bacteria. Prolongation of the carrier state or superinfection may then occur. Interpretation of the biochemical and bacteriological findings of the cerebrospinal fluid is important in distinguishing viral meningitis and encephalitis from bacterial meningitis. If bacterial meningitis is possible, then antibiotics should be used. The indications for antibiotics in viral diseases of the skin, eye, joints, heart and parotid are also discussed.
 ...
PMID:Antibiotics: their true place in the treatment of viral disease. 66 65

The incidence of craniotomy infections, usually less than 5%, is dependent on many factors, such as how the information is collected and how the percentage is calculated. Because these factors may vary from report to report, incidence figures should be read with skepticism. It is difficult to prove that a given factor contributes to infection. Most routines are based more on personal convictions than on solid evidence. CSF leak is one factor known to have great impact; it should be avoided with painstaking technique and, if it occurs, it should be treated promptly. Solid evidence favoring prophylactic antibiotics for persistent CSF leak is not available; but, until a well-designed randomized study tells otherwise, the high risk of meningitis justifies prophylaxis. Penicillin is adequate for leaks through the nose or the ear. For leaks through the skin, the antibiotic should be effective against staphylococci. The infection register should provide information about prevailing bacteria. In many hospitals, the prophylaxis should cover gram-negative bacilli. CRP is a useful diagnostic aid for detecting postoperative infections. The operation, however, also causes a CRP rise. Daily CRP monitoring, at least for patients with elevated temperature, is recommended. The third-generation cephalosporins are a welcome contribution to the treatment of bacterial meningitis. To avoid side effects, and to keep them potent when they are really needed, they should be used with caution. Most postoperative cases of meningitis are in fact aseptic. If the patient is moderately ill, chloramphenicol is still eligible as the first choice antibiotic. When the bacterial culture is negative, the antibiotic should be stopped. The standard treatment for bone flap infection is removal of the bone flap. The bone flap is essentially devascularized and comparable to a foreign body. The justification of vancomycin prophylaxis has been shown in a randomized study.
 ...
PMID:Craniotomy infections. 163 66

The third-generation cephalosporins are useful for empiric therapy of most of the severe infections in adults as a result of their broad spectrum of antimicrobial activity (particularly against clinically important gram-negative bacteria), good tissue penetration, and lack of serious adverse effects. This review examines their use in respiratory tract infections, bacterial meningitis, skin-structure infections, and urinary tract infections in adult patients. Penicillin G remains the optimal therapy for severe community-acquired pneumonia, since Streptococcus pneumoniae still accounts for the majority of cases. However, for empiric treatment of nosocomial pneumonia, therapy must ensure coverage both of aerobic gram-negative bacilli and Staphylococcus aureus. The choice of empiric antibiotic therapy in the treatment of urinary tract infections depends on the pattern of resistance in the patient's environment. At present, the treatment of bacterial meningitis in otherwise healthy adults does not constitute a major problem provided that penicillin resistance among pneumococci and meningococci (responsible for at least 80 percent of cases) does not become a clinical problem. However, in meningitis in which gram-negative bacilli are suspected and where specific problems include antibiotic resistance among these organisms and the inadequate penetration of many antibiotics into the cerebrospinal fluid, third-generation cephalosporins are the drugs of choice, and they have markedly improved the clinical outcome. Most skin-structure infections are due to S. aureus and are best treated by an anti-staphylococcal penicillin or an older cephalosporin. Nevertheless, the third-generation cephalosporins have proved to be highly effective agents for infections of skin and soft-tissue infections associated with both gram-positive and gram-negative pathogens in patients at risk from these organisms or in the elderly.
 ...
PMID:Empiric therapy of severe infections in adults. 218 4

Bacterial meningitis continues to be an important cause of morbidity and mortality despite the availability of effective bactericidal antibiotics. Penicillin or ampicillin remains the drug of choice for meningitis caused by Streptococcus pneumoniae and Neisseria meningitidis. The third generation cephalosporins have revolutionized the treatment of gram-negative meningitis. Future therapy for bacterial meningitis will use recent developments in the understanding of pathogenic and pathophysiologic mechanisms underlying this disease.
 ...
PMID:Bacterial meningitis in adults. 227 93

A 3 year old girl was admitted with suspected bacterial meningitis. The patient's history concerning renal and cerebral function and known allergies had been uneventful until that time. 36 h after initiation of a high dose antibiotic therapy with Penicillin G (0.5 Mega IE/kg/day) and Amoxicillin (400 mg/kg/day) macrohematuria and consecutive anuria was observed. Prerenal cardiocirculatory failure, a Schwartz-Bartter-reaction as well as coagulatory failure could be ruled out. There were no symptoms of hypersensitivity. Sonographic examinations of the kidneys and the urinary tract as well as urinanalysis suggested an acute tubular obstruction and papillary necrosis caused by amoxicillin. After changing the antibiotic regimen to chloramphenicol and induction of diuresis by furosemide and dopamine renal failure could be resolved within 39 h. The patient recovered completely. High dose therapy with amoxicillin (greater than 300 mg/kg/day) includes the risk of tubular obstruction due to cristalluria. Solubility of ampicillin in aqueous fluids (6.5 mg/ml at pH 7) should be supported by sufficient diuresis and urine alkalization.
 ...
PMID:[Acute renal failure with high-dose combination therapy with penicillin G and amoxicillin]. 232 16

Bacterial meningitis in 20 children was treated with cefotaxime. 17 children received this antibiotic throughout the disease as monotherapy, three were changed to Penicillin G (2) or ampicillin (1), after sensitivity of the pathogen was known, although cefotaxime had been effective. All bacterial isolates were highly susceptible to cefotaxime. All CSF cultures were sterile at second tap, performed 24 to 48 hrs after therapy was started. Cefotaxime and desacetyl-cefotaxime concentrations in CSF, measured by HPLC in 9 patients were in the range of 4 to 34 (average 17.6) mg/l and 2.1 to 82 (average: 15.1) mg/l, representing a CSF-serum ratio of 8 to 74% (average 45.6%) for cefotaxime and 25 to 151% (average: 73.7%) for desacetyl-cefotaxime. Clinical outcome was favourable in 17 patients. There were one death and late neurological deficits in three. Cefotaxime monotherapy is recommended instead of standard therapy with chloramphenicol and/or ampicillin because of superior antibacterial activity, lower toxicity and lesser side-effects for primary meningitis in children caused by N. meningitides, S. pneumoniae, or H. influenzae type b.
 ...
PMID:[Cefotaxime monotherapy in bacterial meningitis in childhood]. 379 34

The minimum inhibitory concentrations (MIC) of penicillin G, ampicillin, mezlocillin, azlocillin, cephalothin and cefoxitin were determined for 47 strains of Haemophilus influenzae, 68 strains of Neisseria meningitidis and 45 strains of Streptococcus pneumoniae. These strains were isolated during the past three years from patients with acute bacterial meningitis. Three strains of H. influenzae were ampicillin-resistant while no pneumococcus or meningococcus strain was penicillin-resistant. Mezlocillin was the most potent antibiotic against the Haemophilus and pneumococcus strains, followed closely by azlocillin. Mezlocillin inhibited 77.7% of the meningococci strains tested at a concentration of 0.03 mg/l. Penicillin G was the most effective of the drugs against these strains. It inhibited 100% at a concentration of 0.5 mg/l. The cephalosporins were the least active of the six beta-lactam antibiotics tested.
 ...
PMID:Comparative activity of six beta-lactam antibiotics against strains of Haemophilus influenzae, Neisseria meningitidis and Streptococcus pneumoniae. 681 56

We evaluated the effectiveness of 5-day antibacterial therapy for bacterial meningitis in children. The study group included 26 children from 2 months to 15 years of age, admitted with microbiologically confirmed bacterial meningitis in 1990-1993 and treated for 5 days. A historical comparison group of 49 patients treated for 8 to 15 days was used. Penicillin monotherapy (300 mg/kg body weight) was used for meningococcal and pneumococcal meningitis and ampicillin (300 mg/kg body weight) for Haemophilus influenzae b meningitis. On day 5 of therapy the activity of aspartate aminotransferase (AST), lactic dehydrogenase (LDH), creatine phosphokinase (CPK) and gamma-glutamyl-transpeptidase (gamma GT) in the CSF was determined by photocolorimetric assay and the concentration of creatine kinase BB (CK-BB) by ELISA. IL-6 was analysed using EIA technique and a cerebral ultrasound was performed at the time of the termination of the antibacterial therapy. The mean follow-up time was 1.3 years for children in the study group and 3.2 in the control group. The time of hospitalisation was shorter in children treated for 5 days (p < 0.005). Complete clinical recovery was 81% in the study group and 66% in the comparison group at the time of the termination of antibacterial therapy. No relapses occurred. The activity of AST, CPK, LDH, and gamma GT in the CSF had returned to normal by the 5th day of therapy, but almost a 7-fold higher concentration of CK-BB was registered. The concentration of IL-6 in the CSF decreased with the therapy from 1,800 pg/ml to 685 pg/ml but still remained high.(ABSTRACT TRUNCATED AT 250 WORDS)
 ...
PMID:Five days of antibacterial therapy for bacterial meningitis in children? 762 59

81 patients (pts) with bacterial meningitis hospitalised in the Clinic for Infectious Diseases in the years 1990-1991 were treated according to two therapeutic schedules. First: young pts (under 40 years), without coexisting diseases obtained Penicillin G and aminoglycoside and/or synthetic penicillin. Second: pts over 40 years old with coexisting diseases or cases of recurrent meningitis were treated with third-generation cephalosporins and aminoglycoside and/or synthetic penicillin. The mortality was 16% in the study group. 11 of 13 pts with coexisting diseases died. Neurologic sequelae were found in 23% of pts. The complete recovery was obtained in 34% of pts, more often (35.9%) in a group treated with third--generation cephalosporins comparing to 29.4% with other antibiotic therapy.
 ...
PMID:[Treatment outcome of purulent meningitis in adults from material of the Clinic of Infectious Diseases AM in Lodz in the years 1990-1991]. 765 18

Pneumococci are a leading cause of bacterial meningitis and bacteraemia, as well as pneumonia, otitis media and sinusitis in childhood. These organisms recently have shown a dramatic increase in antibiotic resistance. Penicillin-resistant pneumococci are of special concern as they are often resistant to other unrelated antibiotics. This is of particular significance to Aboriginal children who have among the highest rates of pneumococcal infection in the world. Laboratories should now test all invasive pneumococcal isolates for penicillin and third generation cephalosporin resistance. Local treatment guidelines are required for pneumococcal infections, especially for meningitis, taking into account the prevalence of resistant strains within the community. At present, penicillin and amoxycillin remain the drugs of choice for pneumococcal infections, with the exception of meningitis where initial empirical therapy must be with a third generation cephalosporin. Judicious antibiotic use, which avoids over-prescribing and unnecessary use of broad-spectrum agents, improved living standards in underprivileged communities and introduction of an effective conjugate vaccine, able to reduce the rates of pneumococcal infection and hopefully colonization, may limit the spread of resistant strains.
 ...
PMID:Antibiotic management of pneumococcal infections in an era of increased resistance. 932 14


1 2 3 Next >>