Management for Bacterial Meningitis in Adults

Acute bacterial meningitis is one of life-threatening neurological emergencies. Early diagnosis and effective antibiotic treatment remain as the cornerstone of successful management for bacterial meningitis. Examination of cerebrospinal fluid by lumbar puncture is an undisputable part of assessment for patients who present with symptoms and signs of meningitis unless the procedure is contraindicated by reasons of clinical safety. Gram-stain, culture of bacteria, latex agglutination, and polymerase chain reaction are important tests for detecting causative microorganism. After collecting samples from patient, clinician should start empirical antimicrobial therapy immediately. After identifying the causative microorganism, appropriate antimicrobial agents and duration of therapy should be decided after considering many factors such as information about the microorganism, including its emerging pattern of resistance, environmental factors, host factors including age, sex, site of infection, and underlying disease. This article reviews the general therapeutic principles with the goal to give treatment recommendations for bacterial infections in the central nervous system. J Neurocrit Care 2014;7(2):71-77