Calculated parenteral initial therapy of bacterial infections: Bacterial meningitis

Abstract

This is the thirteenth chapter of the guideline "Calculated initial parenteral treatment of bacterial infections in adults - update 2018" in the 2^nd updated version. The German guideline by the Paul-Ehrlich-Gesellschaft für Chemotherapie e.V. (PEG) has been translated to address an international audience. Bacterial meningitis is a life-threatening infectious disease with high mortality and disability rates requiring prompt initiation of antimicrobial treatment to lower these rates.

Table 1. Calculated antibiotic treatment of bacterial meningitis in adults. The recommendations of the S2k guideline on the treatment of tuberculosis by the German Central Committee for the Control of Tuberculosis e.V. on behalf of the German Society of Pneumology and Respiratory Medicine e.V.

Table 2. Targeted antibiotic treatment of bacterial meningitis in adults [according to guidelines of the German Society of Neurology (http://www.dgn.org)]

Table 3. Intraventricular antibiotic treatment (usually simultaneous systemic treatment is required)

Table 4. Tuberculous meningitis: Dosage recommendations according to national and international guidelines. Due to intolerance or resistance to standard substances of tuberculosis treatment in each case combination treatment with 4 effective tuberculosis drugs should be performed. If necessary, in addition to parenteral administration, only orally available agents (such as PZA, PAS, bedaquiline, delamanid) should be administered. These are therefore also listed in the table.