Improving the outcome of neonatal meningitis

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Abstract
Neonatal meningitis is an important cause of mortality and morbidity worldwide, and although mortality has declined in developed countries over the last two decades, improvement in morbidity has been less evident. This review focuses on recent advances in the management of neonatal meningitis and its implications for improved outcomes. Recent surveillance studies of neonatal meningitis have provided important information regarding the pathogens causing meningitis, their antibiotic-susceptibility profiles and their outcomes. Data supporting the importance of early recognition of the signs of neonatal meningitis, the early diagnosis of the causative pathogen, early and aggressive fluid therapy and supportive care and on the effect of adjunctive therapies on outcome measures are all largely theoretical or derived from paediatric and adult sepsis studies. There is likely to be considerable scope for improving the outcome from neonatal meningitis but more studies are required to define key interventions and to demonstrate their effectiveness.