Prophylaxis of acute bacterial meningitis (excluding the neonatal period)

Abstract

Objective: To review the current practice in the most common pediatric acute bacterial meningitis (ABM). Methods: A literature review from MEDLINE data base. Haemophilus influenzae, Streptococcus pneumoniae and Neisseria meningitidis acute meningitis prevention related papers were selected, preventive strategies were reviewed. Results and Conclussions: Preventive strategies -Chemoprophilaxis: Chemoprophilaxis for N. meningitidis or H. influenzae infection should be done to close contacts (family members, nursery and school contacts, worker care) and to case if intravenous antibiotic therapy is inefective for pharinge sterilization. Rifampicin is the drug of choice (10-20 mg/kg/day in 2 divided doses for 2 and 4 days in N. meningitidis and H. influenzae chemoprophilaxis respectively). Vaccines: N. meningitidis: Vaccines against serotypes A and C N. meningitidis are available and effective, specially in patients aged 18 months or more. H. influenzae type b vaccine is very effective, specially after 2-3 doses. The incidence of invasive H. influenzae type b infection has been decreased sustantially after his use in some countries S. pneumoniae vaccine for the 23 most common serotypes is available. It is recommended for asplenic, immunocomprised and HIV infected patients.