Meningitis Treatment in Men: Antibiotic Use and Results

Treatment of meningitis with antibiotics: Examples and efficiency analysis

Meningitis, an inflammation of the protective membranes covering the brain and spinal cord, can be caused by various pathogens, each requiring different treatment approaches. Here's a breakdown of the typical antibiotic treatments for common bacterial meningitis causes.

Subacute meningitis, which develops over a few days to weeks, can be treated with antibiotics. The choice of antibiotics depends on the causative organism, patient age, and risk factors.

For Streptococcus pneumoniae infection, doctors may prescribe dexamethasone along with the antibiotics, often ceftriaxone or cefotaxime, to combat inflammation and kill the bacteria. In some cases, vancomycin may be added due to resistance concerns, but this is usually switched to penicillin or ampicillin if the bacteria is sensitive.

Neisseria meningitidis, a common cause of meningitis, is usually very sensitive to third-generation cephalosporins like ceftriaxone or cefotaxime.

Haemophilus influenzae meningitis is treated with ceftriaxone or cefotaxime, and the addition of corticosteroids, such as dexamethasone, is recommended to reduce complications.

Group B Streptococcus (S. agalactiae) infections, particularly in neonates, require a combination of antibiotics, often ampicillin or penicillin plus cefotaxime.

Listeria monocytogenes meningitis, common in neonates, the elderly, and immunocompromised individuals, is treated with ampicillin or penicillin plus gentamicin.

Escherichia coli meningitis, often requiring treatment in neonates, may be treated with cefotaxime, ceftriaxone, or cefepime, considering resistance and hospital-acquired strains.

Empiric therapy in adults typically starts with vancomycin plus ceftriaxone to cover resistant pneumococci and common pathogens. For neonates and infants under 1 month, treatment often includes ampicillin plus cefotaxime or gentamicin to cover Listeria and Gram-negative rods.

Additional points: Adjunctive corticosteroids, such as dexamethasone, are commonly given with the first antibiotic dose for H. influenzae and pneumococcal meningitis to reduce inflammation and sequelae. Cefepime can be used for healthcare-associated meningitis or resistant Gram-negative infections, including Pseudomonas aeruginosa. Early initiation of antibiotics is critical and should not be delayed for lumbar puncture when bacterial meningitis is suspected.

Parasitic meningitis, such as eosinophilic meningitis or eosinophilic meningoencephalitis, has no specific treatment. Lyme meningitis is treated with antibiotics such as doxycycline or ceftriaxone. Syphilitic meningitis is treated with intravenous penicillin in doses given every 4 hours for 10-14 days.

Tuberculous meningitis is treated with antitubercular drugs like isoniazid, rifampin, pyrazinamide, and ethambutol. For tuberculosis meningitis, doctors may prescribe isoniazid and rifampin for 7-10 months following 2 months of treatment with other antibiotics. Close contacts may also be treated with antibiotics as a precaution.

It's essential to note that bacterial meningitis requires antibiotic treatment to kill the infectious bacteria. Severe side effects of antibiotics can include C. diff infection, severe allergic reactions, and antibiotic-resistant infections. Common side effects of antibiotics include rash, nausea, diarrhea, and yeast infection.

This tailored approach optimizes bacterial coverage based on the most likely organisms for age and clinical setting while mitigating resistance and complications.