The management of bacterial meningitis in children

Abstract

Bacterial meningitis is still a major cause of death and disability in children worldwide. With the advent of conjugate vaccines against the three major pathogens, the burden of disease is increasingly concentrated in developing countries that cannot afford the vaccines. Antibiotic resistance is an increasing problem; in developed countries, high-level resistance to β-lactams among Streptococcus pneumoniae necessitates the addition of vancomycin to third-generation cephalosporins. In many developing countries, the problems are more fundamental. Increasing resistance of S. pneumoniae to penicillin and chloramphenicol and of Haemophilus influenzae to chloramphenicol means that many children wi..