Template:Steroids Bacterial Meningitis - Revision history

Ostermayer at 22:28, 5 November 2014

2014-11-05T22:28:14Z

← Revisión anterior		Revisión del 22:28 5 nov 2014
Línea 1:		Línea 1:
	*The goal of early glucocorticoids for bacterial meningitis, is to reduce the neurologic morbidity, particularly with [[Streptococcus pneumoniae]]		*The goal of early glucocorticoids for bacterial meningitis, is to reduce the neurologic morbidity, particularly with [[Streptococcus pneumoniae]]
	*Early animal research demonstrated a decrease in hearing loss in rabbits<ref>Bhatt SM et al. Progression of hearing loss in experimental pneumococcal meningitis: correlation with cerebrospinal fluid cytochemistry. J Infect Dis. 1993;167(3):675</ref> and shown in adults in Europe to reduce mortality in patient with [[Streptococcus pneumoniae]] [[Meningitis]]<ref>[[EBQ:De Gans - Steroids for Bacterial Meningitis]]</ref>		*Early animal research demonstrated a decrease in hearing loss in rabbits<ref>Bhatt SM et al. Progression of hearing loss in experimental pneumococcal meningitis: correlation with cerebrospinal fluid cytochemistry. J Infect Dis. 1993;167(3):675</ref> and shown in adults in Europe to reduce mortality in patient with [[Streptococcus pneumoniae]] [[Meningitis]]<ref>[[EBQ:De Gans - Steroids for Bacterial Meningitis]]</ref>
	*However meta-analysis demonstrated no mortality difference overall and '''only''' in the subgroup with cultures positive for [[Streptococcus pneumoniae]] and not those for [~~H. Influenza~~]] or [[Neisseria meningitidis]]<ref>Brouwer MC, McIntyre P, de Gans J, Prasad K, van de Beek D. Corticosteroids for Acute Bacterial Meningitis. Cochrane Database of Systematic Reviews 2010, Issue 9.</ref>		*However meta-analysis demonstrated no mortality difference overall and '''only''' in the subgroup with cultures positive for [[Streptococcus pneumoniae]] and not those for [[Haemophilus influenzae]] or [[Neisseria meningitidis]]<ref>Brouwer MC, McIntyre P, de Gans J, Prasad K, van de Beek D. Corticosteroids for Acute Bacterial Meningitis. Cochrane Database of Systematic Reviews 2010, Issue 9.</ref>
	*Dexamethasone has been shown to decrease blood-brain permeability and therefore antibiotic penetration into subarachnoid space specifically with [[Vancomycin]]<ref>Ricard JD et al. Levels of vancomycin in cerebrospinal fluid of adult patients receiving adjunctive corticosteroids to treat pneumococcal meningitis: a prospective multicenter observational study. Clin Infect Dis. 2007;44(2):250</ref> However increasing the serum concentration of [[Vancomycin]] may increase the CSF levels and can possibly counteract the effects from dexamethasone		*Dexamethasone has been shown to decrease blood-brain permeability and therefore antibiotic penetration into subarachnoid space specifically with [[Vancomycin]]<ref>Ricard JD et al. Levels of vancomycin in cerebrospinal fluid of adult patients receiving adjunctive corticosteroids to treat pneumococcal meningitis: a prospective multicenter observational study. Clin Infect Dis. 2007;44(2):250</ref> However increasing the serum concentration of [[Vancomycin]] may increase the CSF levels and can possibly counteract the effects from dexamethasone
	*The Infectious Disease Society of America recommends the use of dexamethasone in all patients with suspected Strep. Pneumoniae meningitis. <ref>Tunkel AR et al. Practice guidelines for the management of bacterial meningitis. Clin Infect Dis. 2004;39(9):1267</ref> and continuation of the dexamethasone as an in-patient can be continued based on the culture and gram stain results of the CSF		*The Infectious Disease Society of America recommends the use of dexamethasone in all patients with suspected Strep. Pneumoniae meningitis. <ref>Tunkel AR et al. Practice guidelines for the management of bacterial meningitis. Clin Infect Dis. 2004;39(9):1267</ref> and continuation of the dexamethasone as an in-patient can be continued based on the culture and gram stain results of the CSF
	**Suspicion for pneumococcal meningitis can be based on the inclusion criteria from the [[EBQ:De_Gans_-_Steroids_for_Bacterial_Meningitis\|De Gans Study]]		**Suspicion for pneumococcal meningitis can be based on the inclusion criteria from the [[EBQ:De_Gans_-_Steroids_for_Bacterial_Meningitis\|De Gans Study]]

Ostermayer at 22:25, 5 November 2014

2014-11-05T22:25:54Z

← Revisión anterior		Revisión del 22:25 5 nov 2014
Línea 2:		Línea 2:
	*Early animal research demonstrated a decrease in hearing loss in rabbits<ref>Bhatt SM et al. Progression of hearing loss in experimental pneumococcal meningitis: correlation with cerebrospinal fluid cytochemistry. J Infect Dis. 1993;167(3):675</ref> and shown in adults in Europe to reduce mortality in patient with [[Streptococcus pneumoniae]] [[Meningitis]]<ref>[[EBQ:De Gans - Steroids for Bacterial Meningitis]]</ref>		*Early animal research demonstrated a decrease in hearing loss in rabbits<ref>Bhatt SM et al. Progression of hearing loss in experimental pneumococcal meningitis: correlation with cerebrospinal fluid cytochemistry. J Infect Dis. 1993;167(3):675</ref> and shown in adults in Europe to reduce mortality in patient with [[Streptococcus pneumoniae]] [[Meningitis]]<ref>[[EBQ:De Gans - Steroids for Bacterial Meningitis]]</ref>
	*However meta-analysis demonstrated no mortality difference overall and '''only''' in the subgroup with cultures positive for [[Streptococcus pneumoniae]] and not those for [H. Influenza]] or [[Neisseria meningitidis]]<ref>Brouwer MC, McIntyre P, de Gans J, Prasad K, van de Beek D. Corticosteroids for Acute Bacterial Meningitis. Cochrane Database of Systematic Reviews 2010, Issue 9.</ref>		*However meta-analysis demonstrated no mortality difference overall and '''only''' in the subgroup with cultures positive for [[Streptococcus pneumoniae]] and not those for [H. Influenza]] or [[Neisseria meningitidis]]<ref>Brouwer MC, McIntyre P, de Gans J, Prasad K, van de Beek D. Corticosteroids for Acute Bacterial Meningitis. Cochrane Database of Systematic Reviews 2010, Issue 9.</ref>
			*Dexamethasone has been shown to decrease blood-brain permeability and therefore antibiotic penetration into subarachnoid space specifically with [[Vancomycin]]<ref>Ricard JD et al. Levels of vancomycin in cerebrospinal fluid of adult patients receiving adjunctive corticosteroids to treat pneumococcal meningitis: a prospective multicenter observational study. Clin Infect Dis. 2007;44(2):250</ref> However increasing the serum concentration of [[Vancomycin]] may increase the CSF levels and can possibly counteract the effects from dexamethasone
			*The Infectious Disease Society of America recommends the use of dexamethasone in all patients with suspected Strep. Pneumoniae meningitis. <ref>Tunkel AR et al. Practice guidelines for the management of bacterial meningitis. Clin Infect Dis. 2004;39(9):1267</ref> and continuation of the dexamethasone as an in-patient can be continued based on the culture and gram stain results of the CSF
			**Suspicion for pneumococcal meningitis can be based on the inclusion criteria from the [[EBQ:De_Gans_-_Steroids_for_Bacterial_Meningitis\|De Gans Study]]

Ostermayer: Created page with "The goal of early glucocorticoids for bacterial meningitis, is to reduce the neurologic morbidity, particularly with Streptococcus pneumoniae Early animal research demon..."

2014-11-05T22:02:55Z

Created page with "*The goal of early glucocorticoids for bacterial meningitis, is to reduce the neurologic morbidity, particularly with Streptococcus pneumoniae *Early animal research demon..."

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*The goal of early glucocorticoids for bacterial meningitis, is to reduce the neurologic morbidity, particularly with [[Streptococcus pneumoniae]]
*Early animal research demonstrated a decrease in hearing loss in rabbits<ref>Bhatt SM et al. Progression of hearing loss in experimental pneumococcal meningitis: correlation with cerebrospinal fluid cytochemistry. J Infect Dis. 1993;167(3):675</ref> and shown in adults in Europe to reduce mortality in patient with [[Streptococcus pneumoniae]] [[Meningitis]]<ref>[[EBQ:De Gans - Steroids for Bacterial Meningitis]]</ref>
*However meta-analysis demonstrated no mortality difference overall and '''only''' in the subgroup with cultures positive for [[Streptococcus pneumoniae]] and not those for [H. Influenza]] or [[Neisseria meningitidis]]<ref>Brouwer MC, McIntyre P, de Gans J, Prasad K, van de Beek D. Corticosteroids for Acute Bacterial Meningitis. Cochrane Database of Systematic Reviews 2010, Issue 9.</ref>

Template:Steroids Bacterial Meningitis - Revision history

Ostermayer at 22:28, 5 November 2014

Ostermayer at 22:25, 5 November 2014

Ostermayer: Created page with "*The goal of early glucocorticoids for bacterial meningitis, is to reduce the neurologic morbidity, particularly with Streptococcus pneumoniae *Early animal research demon..."

Ostermayer: Created page with "The goal of early glucocorticoids for bacterial meningitis, is to reduce the neurologic morbidity, particularly with Streptococcus pneumoniae Early animal research demon..."