Clinical Review : Acute Bacterial Meningitis in Childhood

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Abstract
When acute purulent meningitis is treated as a medical emergency, the diagnosis made early and the correct medications started im mediately in the proper dosages and by the proper routes, the chances for recovery are excellent. For antibiotic therapy to be most effective, attention must also be directed to anticipating the many complicating hazards, and preventing them. Ampicillin is the antibiotic of first choice. For the child who is allergic to penicillin, chloramphenicol is recommended until the causative organism is identified. The concomitant administration of sulphonamides, streptomycin or other antibiotics is unnecessary and may be harm ful except in the neonatal period when it is recommended to commence therapy with ampicillin and gentamicin. This report outlines in detail the authors' program for the specific and supportive treatment of bacterial meningitis and the preven tion and management of its major complications. The 100 cases most recently treated at The Hospital for Sick Children, Toronto, had a case fatality rate of 2.2 per cent.

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