Conclusions
The treatment of bacterial meningitis was revolutionized by antimicrobial drugs, but therapeutic problems continue. Management decisions regarding the timing and choice of empirical antibiotic therapy, the need for cranial imaging, and the benefits of adjunctive glucocorticoid therapy remain controversial.94 The successful implementation of H. influenzae vaccination and the worldwide use of antibiotics have led to changes in the epidemiology of meningitis and to the emergence of antibiotic resistance. As microbiologic cure within the cerebrospinal fluid becomes increasingly difficult, the need for vaccines against N. meningitidis and S. pneumoniae will increase.95,96 In the next millennium, our success will depend on worldwide scrutiny of the patterns of antibiotic resistance, continued development of new antimicrobial drugs, and more judicious use of the drugs we already have.
Conclusions The treatment of bacterial meningitis was revolutionized by antimicrobial drugs, but therapeutic problems continue. Management decisions regarding the timing and choice of empirical antibiotic therapy, the need for cranial imaging, and the benefits of adjunctive glucocorticoid therapy remain controversial.94 The successful implementation of H. influenzae vaccination and the worldwide use of antibiotics have led to changes in the epidemiology of meningitis and to the emergence of antibiotic resistance. As microbiologic cure within the cerebrospinal fluid becomes increasingly difficult, the need for vaccines against N. meningitidis and S. pneumoniae will increase.95,96 In the next millennium, our success will depend on worldwide scrutiny of the patterns of antibiotic resistance, continued development of new antimicrobial drugs, and more judicious use of the drugs we already have.
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