MANAGEMENT OF BACTERIAL-MENINGITIS IN INF ANTS AND CHILDREN

Since the introduction of the Haemophilus influenzae vaccine, Streptoc occus pneumoniae has become the most common cause of bacterial meningi tis in infants and children. The increasing frequency of S. pneumoniae strains with reduced susceptibility to penicillin has led to the deve lopment of treatment regimens combining a third-generation cephalospor in with either vancomycin or rifadine. Mortality (12%) and morbidity ( 15-30%) are not influenced by the MIC of the causative organism, and t he outcome depends mainly on the time to diagnosis and treatment. In o lder children, group B meningococci are the main cause of bacterial me ningitis, and most fatal outcomes occur during the first 48 h as a res ult of hemodynamic disturbances. Prevention of bacterial meningitis re sts on vaccination against Haemophilus influenzae, with the first dose being given at two months of age, and on appropriate antimicrobial th erapy of middle ear infections.