Antibiotic treatment of the five principles of meningitis

Meningitis is a central nervous system infection, a higher mortality rate, the key to effective treatment is strict adherence to the five principles of antibiotics. 1, use fungicides. Meningeal infection in humans usually weak regional defense functions, the existence of the blood-brain barrier because of the lymphatic system and the reasons for the humoral and cellular immune dysfunction, and the absence of specific antibodies and complement, the application of antibacterial drugs therefore very poor results, only Application of fungicides can be a good way to remove bacteria in the cerebrospinal fluid. 2, use of drugs through the blood-brain barrier. Based on various antibacterial drugs through the blood-brain barrier into the cerebrospinal fluid concentrations, can be divided into four categories: general dose to be effective in the cerebrospinal fluid in the main concentration of chloramphenicol, sulfonamides, metronidazole, and isoniazid, rifampicin, ethambutol, and other anti-TB drugs; large intravenous dose of up to the main concentration of penicillin, ampicillin, cephalosporins, as well as ciprofloxacin, sparfloxacin oxygen Star; larger dose in the cerebrospinal fluid in only trace amount of the drug gentamicin, erythromycin, vancomycin; not measured in cerebrospinal fluid polymyxin how the drug, amphotericin B, Lin such as Adriamycin. 3, to avoid adverse reactions greater local administration. Including intrathecal administration and intraventricular administration. Only suffering from cryptococcal meningitis can be supplemented with amphotericin B ventricle or intrathecal administration. 4, the development of rational drug programme. Septic cerebrospinal fluid may be due to weakening of the antibacterial activity of antibiotics, in the development of treatment options, to consider using dose so that the drug concentration in cerebrospinal fluid to maintain a relatively high level. Intravenous route of administration in the main, intermittent or sustained. Of particular note was the improvement in the condition when the reduction should not arbitrarily, as it is infection control, reduce inflammation, blood-brain barrier permeability also will be reduced, if this reduction is difficult to maintain an effective antibiotic concentrations in cerebrospinal fluid, therefore need Application of the whole adequate antibiotics. 5, should achieve an effective drug treatment. Short-term antibiotic treatment high recurrence rate. To develop treatment varies for different pathogens: such as meningococcal meningitis caused treatment for 5 - 7 days, Haemophilus influenzae meningitis not less than 10 days, pneumococcal meningitis should be 14 days, and Gram-negative treatment of meningitis caused by at least 3 - 4 weeks. Indications for its withdrawal in cerebrospinal fluid cell count and biochemical indicators basically returned to normal, smear and culture negative bacteria. In short, bacterial meningitis antibiotic treatment must adhere to the "early, full, adequate, safe and effective" in order to improve the cure rate and lower mortality.