[治疗脑膜炎的时间,新生儿期除外]。

Pediatrie Pub Date : 1993-01-01
B Quinet
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引用次数: 0

摘要

细菌性脑膜炎的最佳治疗提出了三个问题:哪种抗生素?剂量?哪个时间?自过去十年以来,抗生素治疗的总持续时间缩短了。如果短期治疗显示出相似的疗效和复发率,则不必要的延长疗程会增加费用、住院时间和继发效应。从1979年开始,多伦多的Gold等人对所有无并发症的脑膜炎病例进行了7天的治疗,获得了满意的结果。1985年,Lin等人首次进行了评估脑膜炎最佳治疗时间的随机试验:常规治疗和短期治疗在疗效和并发症方面没有差异。目前脑膜炎球菌性脑膜炎的治疗规定为7天或更短时间,肺炎球菌性脑膜炎或嗜血杆菌性脑膜炎的治疗规定为7-10天。c反应蛋白(CRP)水平的连续随访似乎是管理细菌性脑膜炎的有用工具。
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[Duration of the treatment of meningitis except in the neonatal period].

Optimal treatment of bacterial meningitis raises three questions: which antibiotic? which dosage? which duration? The overall duration of antibiotherapy has been shortened since the last decade. If a short-course treatment shows similar efficacy and rate of relapse, unnecessary prolonged course of treatment exposes to increased cost, duration of hospitalization and secondary effects. From 1979, Gold et al in Toronto treated all uncomplicated cases of meningitis for seven days and obtained satisfactory results. The first randomized trials evaluating optimal duration of treatment in meningitis were performed in 1985 by Lin et al: they showed no difference in terms of efficacy and complications between conventional and short-term treatment. Current rules in meningococcal meningitis consist of seven days or less on therapy, and 7-10 days for pneumococcal or Haemophilus meningitis. The sequential follow-up of C-reactive protein (CRP) levels seems a useful tool for the management of bacterial meningitis.

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