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Bacterial meningitis in children and adults. Changes in community-acquired disease may affect patient care.

Phillips EJ, Simor AE
Postgrad Med. 1998 103 (3): 102-117

PMID: 9519033 · DOI:10.3810/pgm.1998.03.412

Despite improved understanding of how bacterial meningitis develops, the infection remains a potentially life-threatening emergency capable of causing significant morbidity and mortality. Since the introduction and widespread use of H influenzae type b vaccine in infancy and childhood in North America, the epidemiology of community-acquired bacterial meningitis has changed. S pneumoniae is now the most common cause in children and adults overall, although N meningitidis causes most disease in patients between ages 2 and 18 years. Broad-spectrum cephalosporins (eg, ceftriaxone, cefotaxime) are considered the agents of choice for empirical treatment of bacterial meningitis. However, use of these agents will have to be reconsidered if the incidence of invasive infection from drug-resistant S pneumoniae continues to increase. The role of adjunctive corticosteroid therapy needs to be better defined. Improved conjugate pneumococcal and meningococcal vaccines may soon make bacterial meningitis a preventable disease.

MeSH Terms (10)

Adrenal Cortex Hormones Adult Anti-Bacterial Agents Child Community-Acquired Infections Drug Resistance, Microbial Drug Therapy, Combination Humans Meningitis, Bacterial North America

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