Glycerol adjuvant therapy in adults with bacterial meningitis in a high HIV seroprevalence setting in Malawi: a double-blind, randomised controlled trial

Ajdukiewicz, Katherine M.B.; Cartwright, Katharine; Scarborough, Matthew; Mwambene, J B; Goodson, Patrick; Molyneux, Malcolm E.; Zijlstra, Eduard E.; French, Neil; Whitty, Christopher J M; Lalloo, David G.

doi:10.1016/s1473-3099(10)70317-0

Cited by 82 publications

(83 citation statements)

References 34 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Its use as an adjunctive therapy in children is supported by one prospective, double-blind trial that demonstrated a statistically significant reduction in neurologic sequelae in the glycerol treatment group compared with the placebo group, but subsequent studies in experimental animals and children with bacterial meningitis did not reveal such benefits [115]. A recent double-blind randomized controlled trial in adults revealed that there was no benefit from glycerol for death and disability in patients with bacterial meningitis [116]. Glycerol has been reported to cause seizures in mice.…”

Section: Glycerolmentioning

confidence: 99%

Treatment of bacterial meningitis: an update

Shin

Kim

2012

Expert Opinion on Pharmacotherapy

View full text Add to dashboard Cite

Prompt treatment of bacterial meningitis with an appropriate antibiotic is essential. Optimal antimicrobial treatment of bacterial meningitis requires bactericidal agents able to penetrate the blood-brain barrier (BBB), with efficacy in cerebrospinal fluid (CSF). Several new antibiotics have been introduced for the treatment of meningitis caused by resistant bacteria, but their use in human studies has been limited. More complete understanding of the microbial and host interactions that are involved in the pathogenesis of bacterial meningitis and associated neurologic sequelae is likely to help in developing new strategies for the prevention and therapy of bacterial meningitis.

show abstract

Section: Glycerolmentioning

confidence: 99%

Treatment of bacterial meningitis: an update

Shin

Kim

2012

Expert Opinion on Pharmacotherapy

View full text Add to dashboard Cite

show abstract

“…Conversely, in a doubleblinded, placebo-controlled, randomized study in adults with a high prevalence of HIV infection and suspected bacterial meningitis in Malawi, 75 ml glycerol administered four times a day for 96 h was not beneficial concerning death and disability by day 40 in the overall study population, and glycerol did not reduce death and disability in patients with proven bacterial disease or pneumococcal disease. Moreover, glycerol increased the day 40 mortality rate from 49 to 63% (adjusted odds ratio: 2.4; 95% CI: 1.3-4.2; p = 0.003)[135]. In Malawian children, glycerol administered for 48 h was ineffective, but did not harm the children[136].…”

mentioning

confidence: 94%

Bacterial meningitis: an update of new treatment options

Nau

Djukic

Spreer

et al. 2015

Expert Review of Anti-infective Therapy

View full text Add to dashboard Cite

The outcome of bacterial meningitis critically depends on the rapid initiation of bactericidal antibiotic therapy and adequate management of septic shock. In community-acquired meningitis, the choice of an optimum initial empirical antibiotic regimen depends on the regional resistance patterns. Pathogens resistant to antibacterials prevail in nosocomial bacterial meningitis. Dexamethasone is recommended as adjunctive therapy for community-acquired meningitis in developed countries. In comatose patients, aggressive measures to lower intracranial pressure <20 mmHg (in particular, external ventriculostomy, osmotherapy and temporary hyperventilation) were effective in a case-control study. Although many experimental approaches were protective in animal models, none of them has been proven effective in patients. Antibiotics, which are bactericidal but do not lyse bacteria, and inhibitors of matrix metalloproteinases or complement factor C5 appear the most promising therapeutic options. At present, vaccination is the most efficient method to reduce disease burden. Palmitoylethanolamide appears promising to enhance the resistance of the brain to infections.

show abstract

“…Minimum incidence rates of adult bacterial meningitis in SSA exceed 10/100,000 adults per year [34], and the associated mortality rates vary between 54 and 70% with high rates of disabling neurological sequelae [99,100]. This high burden of disease has persisted into the post-ART era [98,101].…”

Section: Brain Infectionsmentioning

confidence: 99%

Management of severe non-TB bacterial infection in HIV-infected adults

Gaskell¹,

Feasey

Heyderman

2015

Expert Review of Anti-infective Therapy

View full text Add to dashboard Cite

Despite widespread antiretroviral therapy use, severe bacterial infections (SBI) in HIV-infected adults continue to cause significant morbidity and mortality globally. Four main pathogens account for the majority of documented SBI: Streptococcus pneumoniae, non-typhoidal strains of Salmonella enterica, Escherichia coli and Staphylococcus aureus. The epidemiology of SBI is dynamic, both in developing countries where, despite dramatic successes in antiretroviral therapy, coverage is far from complete, and in settings in both resource-poor and resource-rich countries where antiretroviral therapy failure is becoming increasingly common. Throughout the world, this complexity is further compounded by rapidly emerging antimicrobial resistance, making management of SBI very challenging in these vulnerable patients. We review the causes and treatment of SBI in HIV-infected people and discuss future developments in this field.

show abstract

Glycerol adjuvant therapy in adults with bacterial meningitis in a high HIV seroprevalence setting in Malawi: a double-blind, randomised controlled trial

Cited by 82 publications

References 34 publications

Treatment of bacterial meningitis: an update

Treatment of bacterial meningitis: an update

Bacterial meningitis: an update of new treatment options

Management of severe non-TB bacterial infection in HIV-infected adults

Contact Info

Product

Resources

About