Bacterial meningitis: Principles and practical aspects of therapy

Aronin, Steven I.

doi:10.1007/s11908-000-0013-0

Cited by 19 publications

(9 citation statements)

References 40 publications

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“…Ampicillin remains the preferred drug for treatment of bacterial meningitis [22]. However, our present results showed that ampicillin in the early stage of treatment substantially worsen bacterial meningitis evidenced by the increases of mean CSF leukocyte counts and protein concentration.…”

Section: Discussioncontrasting

confidence: 49%

“…Acute bacterial meningitis can progress extremely fast and cause death within hours or days without appropriate diagnosis and treatment -so utmost caution is required [5,22]. Inflammation of bacterial meningitis is initiated by bacterial cell-wall constituents and cytotoxins in the subarachnoidal space.…”

Section: Discussionmentioning

confidence: 99%

“…Baicalin was also reported anti-inflammation by inhibiting chemokines binding to human leukocytes or cells transfected to express specific chemokine receptors to reduce the capacities of chemokine-induced cell migration [11]. Based on previous researches showing that the inflammatory response in bacterial meningitis is mediated by cytokines, such as TNF-a and IL-1 [22,40], together with our present results, we propose that baicalin protect against brain edema and damage in experimental E. coli bacterial meningitis due at least in part to reducing IL-1 and TNF-α production. The action mechanisms by which baicalin modulates IL-1 and TNF-α production remain unclear.…”

Section: Discussionmentioning

confidence: 99%

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Multiple Therapeutic Effects of Adjunctive Baicalin Therapy in Experimental Bacterial Meningitis

et al. 2009

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This study aimed to examine effects of adjunctive baicalin therapy to ampicillin for experimental bacterial meningitis in rabbits. After Escherichia Coli inoculation, mean leukocyte counts, concentrations of protein, tumor necrosis factor-alpha (TNF-alpha), interleukin-1 (IL-1) and lactate in cerebrospinal fluid (CSF), brain water content and mean arterial and intracranial pressures substantially increased in the meningitis group. Ampicillin alone for 5 h markedly exacerbated the enhanced leukocyte counts and protein concentration, and showed no significant effect on the elevated CSF TNF-alpha, IL-1 and lactate concentration, mean arterial and intracranial pressures, and brain water content. Baicalin (7-D-glucuronic acid-5,6-dihydroxyflavone, C(21)H(18)O(11)) completely counteracted ampicillin-induced exacerbation, and further alleviated the enhanced mean leukocyte counts and protein concentration when combined with ampicillin. Adjunctive baicalin also significantly ameliorated the elevated CSF TNF-alpha, IL-1 and lactate concentration, mean arterial and intracranial pressures, and brain water content. Baicillin, as an adjunctive treatment exerted multiple therapeutic effects in experimental bacterial meningitis.

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Section: Discussioncontrasting

confidence: 49%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Multiple Therapeutic Effects of Adjunctive Baicalin Therapy in Experimental Bacterial Meningitis

et al. 2009

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“…Therefore a rapid and accurate clinical evaluation is needed for the determination of risks due to meningitis [2] . Examination of cerebrospinal fl uid (CSF) is an important diagnostic tool.…”

Section: Introductionmentioning

confidence: 99%

Thwaites’ Diagnostic Scoring and the Prediction of Tuberculous Meningitis

Sünbül¹,

Atilla²,

Esen³

et al. 2005

Med Princ Pract

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Objective: This study was conducted to investigate the applicability of Thwaites’ diagnostic criteria in order to differentiate tuberculous from bacterial meningitis. Material and Methods: The study was done retrospectively in HIV-negative patients (n = 126) with meningitis. Of the 126 patients, 103 had bacterial meningitis and 23 patients had tuberculous meningitis. The diagnosis was confirmed microbiologically in 59 and 12 patients with bacterial and tuberculous meningitis, respectively. The prediction of tuberculous meningitis was determined by Thwaites’ diagnostic scoring using parameters such as age, history of illness, white blood cell count, total cerebrospinal fluid (CSF) white cell count and the percent of neutrophils in CSF. The diagnostic value of the model was assessed by calculating the area under the receiver operating characteristic (ROC) curves. Results: The sensitivity and the specificity of Thwaites’ diagnostic scoring were 95.6% (22/23) and 70.8% (73/103), respectively. In microbiologically proven cases the sensitivity and the specificity were 91.7% (11/12), 79.7% (57/59), respectively. The area under the ROC curve value for the diagnostic scoring was 0.92. Conclusions: Thwaites’ diagnostic score was found to be helpful in differential diagnosis of tuberculous meningitis, however, the usefulness of diagnostic scoring should be validated in large series especially in patients with viral meningitis and low CSF glucose levels.

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“…Knowledge of the pharmacodynamic properties of antimicrobials allows for appropriate optimization of bactericidal drug concentrations (Lutsar et al, 1998;Aronin, 2000). Bacterial killing is particularly important in the CSF in which there is a decreased immune response from relatively lower concentrations of antibody and complement and inefficient phagocytosis.…”

Section: Antimicrobial Pharmacodynamics In Csfmentioning

confidence: 99%

Bacterial meningitis: An update review

Bekairy¹,

Harbi²,

Alkatheri³

et al. 2014

Afr. J. Pharm. Pharmacol.

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Bacterial meningitis is still considered serious life-threatening disease in spite of the decline in the morbidity and mortality in the last decade. The expeditious diagnosis of the disease, a prompt empiric antibiotic treatment and the proper adjunctive therapy are corner stones for the successful management of the disease. The objective of this review is to provide the health care professionals with an update of reference for bacterial meningitis diagnosis and treatment. In addition, the various types of vaccines and the empiric chemoprophylaxis treatment are reviewed.

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Bacterial meningitis: Principles and practical aspects of therapy

Cited by 19 publications

References 40 publications

Multiple Therapeutic Effects of Adjunctive Baicalin Therapy in Experimental Bacterial Meningitis

Multiple Therapeutic Effects of Adjunctive Baicalin Therapy in Experimental Bacterial Meningitis

Thwaites’ Diagnostic Scoring and the Prediction of Tuberculous Meningitis

Bacterial meningitis: An update review

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