REASONS FOR DELAY IN ADMINISTRATION OF ANTIBIOTICS TO PATIENTS WITH MENINGITIS AND MENINGOCOCCEMIA

To determine the extent of, and reasons for, delay in treatment of pat ients with bacterial meningitis or meningococcal septicaenia, we revie wed the case notes of all adults admitted to Addenbrooke's Hospital, C ambridge with these diagnoses over a 3 year period. Thirty-three patie nts were identified. Some 70% (21/30) patients admitted via their GPs were not treated before admission. In 12 of these cases, the diagnosis was not considered. Nine patients were not treated despite the diagno sis of meningitis being considered possible or likely; in two cases th is was due to suspected penicillin allergy, but no reason was given fo r the remaining seven. Of 24 patients untreated prior to hospital admi ssion, only nine were given antibiotics before lumbar puncture had bee n performed. Failure to treat meningitis and meningococcaemia most oft en resulted from failure to consider the diagnosis, but treatment was delayed in a significant number of case for no obvious reason. General practitioners and hospital doctors need to have a low threshold for a dministering antibiotics as soon as the diagnosis of bacterial meningi tis or meningococcaemia is considered possible.