Treatment

Osmotic therapies added to antibiotics for acute bacterial meningitis

Abstract Background Every day children and adults die from acute community-acquired bacterial meningitis, particularly in low-income countries, and survivors risk deafness, epilepsy and neurological disabilities. Osmotic therapies may attract extra-vascular fluid and reduce cerebral oedema, and thus reduce death and improve neurological outcomes. This is an update of a Cochrane Review first published in 2013. […]

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Intravenous immunoglobulin for the treatment of childhood encephalitis

Abstract Background Encephalitis is a syndrome of neurological dysfunction due to inflammation of the brain parenchyma, caused by an infection or an exaggerated host immune response, or both. Attenuation of brain inflammation through modulation of the immune response could improve patient outcomes. Biological agents such as immunoglobulin that have both anti-inflammatory and immunomodulatory properties may […]

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Pre-admission antibiotics for suspected cases of meningococcal disease

Abstract Background Meningococcal disease can lead to death or disability within hours after onset. Pre-admission antibiotics aim to reduce the risk of serious disease and death by preventing delays in starting therapy before confirmation of the diagnosis. Objectives To study the effectiveness and safety of pre-admission antibiotics versus no pre-admission antibiotics or placebo, and different […]

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Antibiotics for the neurological complications of Lyme disease

Abstract Background Various central nervous system-penetrant antibiotics are bactericidal in vitro and in vivo against the causative agent of Lyme neuroborreliosis (LNB), Borrelia burgdorferi. These antibiotics are routinely used clinically to treat LNB, but their relative efficacy is not clear. Objectives To assess the effects of antibiotics for the treatment of LNB. Search methods On […]

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Fluid therapy for acute bacterial meningitis

Abstract Background Acute bacterial meningitis remains a disease with high mortality and morbidity rates. However, with prompt and adequate antimicrobial and supportive treatment, the chances for survival have improved, especially among infants and children. Careful management of fluid and electrolyte balance is an important supportive therapy. Both over- and under-hydration are associated with adverse outcomes. […]

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Corticosteroids for managing tuberculous meningitis

Abstract Background Tuberculous meningitis is a serious form of tuberculosis (TB) that affects the meninges that cover a person’s brain and spinal cord. It is associated with high death rates and with disability in people who survive. Corticosteroids have been used as an adjunct to antituberculous drugs to treat people with tuberculous meningitis, but their […]

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Corticosteroids for acute bacterial meningitis

Abstract Background In experimental studies, the outcome of bacterial meningitis has been related to the severity of inflammation in the subarachnoid space. Corticosteroids reduce this inflammatory response. Objectives To examine the effect of adjuvant corticosteroid therapy versus placebo on mortality, hearing loss and neurological sequelae in people of all ages with acute bacterial meningitis. Search […]

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Corticosteroids for parasitic eosinophilic meningitis

Abstract Background Angiostrongylus cantonensis (A. cantonensis) is the major cause of infectious eosinophilic meningitis. Dead larvae of this parasite cause inflammation and exacerbate symptoms of meningitis. Corticosteroids are drugs used to reduce the inflammation caused by this parasite. Objectives To assess the efficacy and safety of corticosteroids for the treatment of eosinophilic meningitis. Search methods […]

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Trypanocidal drugs for chronic asymptomatic Trypanosoma cruzi infection

Abstract Background Prevention of chronic chagasic cardiomyopathy (CCC) by treating infected populations with trypanocidal therapy (TT) remains a challenge. Despite a renewed enthusiasm for TT, uncertainty regarding its efficacy, concerns about its safety and limited availability remain barriers for a wider use of conventional drugs. We have updated a previous version of this review. Objectives […]

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Intraventricular antibiotics for bacterial meningitis in neonates

Abstract Background Neonatal meningitis may be caused by bacteria, especially gram-negative bacteria, which are difficult to eradicate from the cerebrospinal fluid (CSF) using safe doses of antibiotics. In theory, intraventricular administration of antibiotics would produce higher antibiotic concentrations in the CSF than intravenous administration alone, and eliminate the bacteria more quickly. However, ventricular taps may […]

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