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"Clinical Practice Guidelines for the Management of Bacterial Meningitis"

Published: Clinical Infectious Diseases ; 2004 ; 39 : 1267 -1284


The objective of these practice guidelines is to provide clinicians with recommendations for the diagnosis and treatment of bacterial meningitis. Patients with bacterial meningitis are usually treated by primary care and emergency medicine physicians at the time of initial presentation, often in consultation with infectious diseases specialists, neurologists, and neurosurgeons. In contrast to many other infectious diseases, the antimicrobial therapy for bacterial meningitis is not always based on randomized, prospective, double-blind clinical trials, but rather on data initially obtained from experimental animal models of infections. A model commonly utilized is the experimental rabbit model, in which animals are anesthetized and placed in a stereotactic frame. In this procedure, the cisterna magna can be punctured for frequent sampling of CSF and injection of microorganisms. Frequent sampling of CSF permits measurement of leukocytes and chemical parameters and quantitation of the relative penetration of antimicrobial agents into CSF and the effects of meningitis on this entry parameter, the relative bactericidal efficacy (defined as the rate of bacterial eradication) within purulent CSF, and CSF pharmacodynamics. Results obtained from these and other animal models have led to clinical trials of specific agents in patients with bacterial meningitis. 

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*The 2004 Practice Guidelines for the Management of Bacterial Meningitis has been split into two guidelines. The nosocomial guideline was published in 2017. For recommendations on community acquired, please see the original guideline in 2004.

*This guideline is being either under reviewed to determine if it requires updating or is on the slate to be updated. Please use this version with discretion, as it possible that some information may be outdated.


For information on the recommendations of this guideline, please visit the following link

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