Navigation Links
Clinical Guidelines Help Identify Which Children at Risk of Bacterial Meningitis

Chicago: A set of guidelines have been developed that can help predict the risk of bacterial meningitis for children with cerebrospinal fluid pleocytosis (presence of greater// number of white blood cells than normal), reducing unnecessary hospitalizations and antibiotics, according to a study.

Although bacterial meningitis is the greatest concern when evaluating and treating children with cerebrospinal fluid (CSF) pleocytosis, the majority of these children have viral rather than bacterial meningitis, according to background information in the article. However, because exclusion of bacterial meningitis requires negative CSF (and blood) cultures after 2 to 3 days of incubation, most children with CSF pleocytosis are admitted to the hospital to receive broad-spectrum antibiotics while awaiting culture test results. A highly accurate decision support tool that could identify which children with CSF pleocytosis had a near-zero risk of bacterial meningitis by using clinical and laboratory measures readily available at the time the child is in the clinic could guide decision making and limit unnecessary hospital admissions and prolonged antibiotic use.

Lise E. Nigrovic, M.D., M.P.H., of Children's Hospital Boston and Harvard Medical School, and colleagues conducted a study to validate in a large population the clinical prediction rule, the Bacterial Meningitis Score, which classifies patients at very low risk of bacterial meningitis if they lack 5 criteria, which include certain CSF measurements and a history of seizure. The multicenter study was conducted in the emergency departments of 20 U.S. academic medical centers between January 2001 and June 2004 and included 3,295 children, age 29 days to 19 years with CSF pleocytosis.

Among these patients, 121 (3.7 percent) had bacterial meningitis and 3,174 (96.3 percent) had aseptic (nonbacterial) meningitis. Of the 1,714 patients categorized as very low risk by the Bacterial Meningitis Score, only 2 had bacterial meningitis (both were younger than 2 months old) and 1,712 had aseptic meningitis. The sensitivity of the Bacterial Meningitis Score (i.e., having 1 or more Bacterial Meningitis Score risk factor) for bacterial meningitis was 98.3 percent and the specificity was 61.5 percent.

The authors write that for patients with at least 1 Bacterial Meningitis Score risk factor or who are younger than 2 months, they suggest admission to the hospital and administration of parenteral (ad ministered intravenously or by injection) antibiotics.

'In the conjugate H influenzae type b and pneumococcal vaccines era, bacterial meningitis has become an uncommon disease in U.S. children. Therefore, the majority of children with CSF pleocytosis have aseptic rather than bacterial meningitis. Furthermore, our study confirms that most children with CSF pleocytosis are admitted to the hospital to receive parenteral antibiotics while awaiting bacterial culture test results. Using the Bacterial Meningitis Score prediction rule to assist with clinical decision making could substantially reduce unnecessary hospital admissions for children with CSF pleocytosis at very low risk of bacterial meningitis. Future investigations should study the clinical implementation of the Bacterial Meningitis Score as a guide to help care for children with CSF pleocytosis,' the researchers conclude.

Source-JAMA
'"/>




Related medicine news :

1. Clinical trials need to be more frank
2. Physicians Lack Clinical Guidelines For Treating Elderly With Multiple Illnesses
3. The Growing Rise In Clinical Research Could Lead To A Compromise In Quality Of Research And Ethics
4. Clinical Comparisons Between ADHD Drugs Are Less
5. A Novel System For Clinical Banking Of Umbilical Cord Blood
6. Clinical Renal Trails Do Not Have Sufficient Women Participants
7. Clinical Trials of New Drug Febuxostat Show Promise in Gout Treatment
8. Clinical Trials Of New Anti-Cancer Drug To Be Initiated In New Zealand
9. Green Tea Consumption Found To Improve Clinical Outcome In Cancer Patients
10. Cancer Clinical Research in India
11. New Generation Clinical Trials Could Save Time And Money, Improve Patient Care
Post Your Comments:
*Name:
*Comment:
*Email:


(Date:4/25/2017)... ... April 25, 2017 , ... ... announces Mirroring360 Pro . This new addition to the Mirroring360 product family ... education and business. , Mirroring360 Pro enables educators, business professionals and individuals to ...
(Date:4/25/2017)... , ... April 25, 2017 , ... A stressful work ... work can also decrease overall productivity and performance in the workplace. The goal of ... During the last few weeks of April, Clearview Resolution Services will be shutting down ...
(Date:4/25/2017)... ... 25, 2017 , ... The doctors at Wall Centre Dental are now expanding ... and require sedation to receive dental care. The doctors offer three treatment options to ... cleanings to oral surgery, at their dental office in Vancouver. Wall Centre Dental is ...
(Date:4/25/2017)... ... April 25, 2017 , ... As pharmaceutical companies are held ... with process innovation in drug formulation and manufacturing. CoreRx offers its clients ... equipment in support of their development and manufacturing goals. , The company ...
(Date:4/25/2017)... , ... April 25, 2017 , ... Buyers and sellers ... users to dispensaries and head shops –can’t help but be heartened by the industry’s ... tell-tale cannabis odor aptly described as “skunk smell.” At last they can simply, ...
Breaking Medicine News(10 mins):
(Date:4/18/2017)... , April 18, 2017  Cardinal Health (NYSE: ... fiscal 2017 earnings per share (EPS) guidance and ... This is in conjunction with this morning,s announcement of ... Thrombosis and Nutritional Insufficiency businesses. Cardinal Health ... operations will be at the bottom of its previous ...
(Date:4/18/2017)... DALLAS , April 18, 2017 Viverae ... proud to announce the integration of IBM ® ... platform to deliver targeted communications for a personalized experience. ... meaningful actions on their health in real time. The ... that matter most to members, wherever they are in ...
(Date:4/18/2017)... DIEGO , April 18, 2017  Astute Medical, ... a case series to be presented at the 2017 ... which begins today and continues through April 22. Physicians ... IGFBP-7 , used to assess risk for acute kidney ... decompensated heart failure (ADHF). Elevated levels ...
Breaking Medicine Technology: