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.


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:

(Date:11/27/2015)... ... 2015 , ... Consistent with the Radiology Business Management ... Radiology Marketing Programs meeting will showcase some of the best 2015 radiology ... Palace in Las Vegas with a pre-conference session on a collaborative approach for ...
(Date:11/27/2015)... Minn. (PRWEB) , ... November 27, 2015 , ... ... start failing. Secura Consultants has prided itself for not only fulfilling the needs ... income protection solutions at an affordable price and providing top-tier customer service. However, ...
(Date:11/27/2015)... , ... November 27, 2015 , ... ... largest, most successful and prominent nonprofit healthcare organizations in the country. They have ... with various organizations, and helped advance the healthcare industry as a whole through ...
(Date:11/27/2015)... ... , ... Indosoft Inc., developer and distributor of the world-class ... (Long Term Support) into its Q-Suite 5.10 product line. , Making the change ... version of Asterisk that will receive not only security fixes, but feature and ...
(Date:11/26/2015)... ... November 26, 2015 , ... CognisantMD ... for diagnostic imaging in the Waterloo region. Using the Ocean Platform, family physicians ... directly from their electronic medical record (EMR) without the need for redundant patient ...
Breaking Medicine News(10 mins):
(Date:11/25/2015)... , Nov. 25, 2015 On Tuesday, ... federal bellwether trial against Wright Medical Technology, Inc. ... their Conserve metal-on-metal hip implant device, awarded $11 ... a two week trial and three days of ... hip device was defectively designed and unreasonably dangerous, ...
(Date:11/25/2015)... Nov. 25, 2015  Henry Schein, Inc., the world,s ... office-based dental, medical and animal health practitioners, will unveil ... Henry Schein ConnectDental® Pavilion , which brings together ... open solutions designed to help any practice or laboratory ... for a schedule of experts appearing at the ...
(Date:11/25/2015)... 2015 Allergan plc (NYSE: AGN ) today ... New York State Attorney General,s Office to ... and other statutes with the Attorney General over the decision ... marketing and selling the now generic version of memantine immediate ... liability, has released its counterclaims against New York ...
Breaking Medicine Technology: