Antibiotisk initialbehandling ved purulent meningitis hos voksne. En opgörelse ved danske
hospitalsafdelinger i år 2000
Engelsk titel: Initial antibiotic therapy of purulent meningitis in adults. An investigation of practice patterns in
Danish hospital departments in 2000
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Författare:
Meyer CN
Språk: Dan
Antal referenser: 19
Dokumenttyp:
Artikel
UI-nummer: 03011831
Sammanfattning
Introduction: A previous report demonstrated profound variation in the recommended empirical antibiotic therapy for adult purulent meningitis in Denmark. At present, the only existing "official" recommendation (from the Danish Medical Association) is penicillin monotherapy for all adults, irrespective of age, as the prevalence of penicillin-resistant pneumococci is less than 3 %. Material and methods: A questionnaire concerning empirical antibiotic therapy and the treatment of specific micro-organisms was sent to the 125 departments of internal medicine, infectious diseases, clinical microbiology, neurosurgery, otorhinolaryngology, and neurology in 2001. Results: Consensus was not found in the 93 % who replied, neither within or between the medical specialities nor within or between the counties. The departments of medicine and clinical microbiology were evenly distributed between two strategies: 1) a third-generation cephalosporin plus a penicillin, or 2) penicillin monotherapy, in supplemented in few departments with an aminoglycoside. For Haemophilus influenzae meningitis, 20 % of the departments used ampicillin, whereas the majority preferred ceftriaxone. Discussion: Consensus on empirical antibiotic treatment of purulent meningitis in adults had still not been reached in Denmark in the year 2000, and regimens other than that recommended by the Danish Medical Association were used. Complete and updated information is lacking on the resistance-patterns of bacteria inducing meningitis, and a complete national clinical microbiological database could form the basis for an evidence-based national consensus.