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Clinical Guidelines Help Identify Which Children at Risk of 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
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