Drug Treatment of Bacterial Meningitis Quiz

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Questions and Answers

Which type of antibiotics generally penetrate the CSF only when the meninges are inflamed?

Vancomycin

Chloramphenicol

Aminoglycosides (correct)

Metronidazole

What is the most important consideration for the choice of empiric antibiotic treatment in acute bacterial meningitis?

Availability of antibiotics in the region

Regional rate of decreased susceptibility to penicillin (correct)

Type of bacteria causing meningitis

Patient's gender

Which antibiotic can penetrate the CSF even when the meninges are not inflamed?

Isoniazid (correct)

Rifampicin

Quinolones

Vancomycin

What is the primary action required for acute bacterial meningitis?

Urgent administration of antibiotics Signup and view all the answers

Which type of antibiotics generally penetrate the CSF poorly under all circumstances?

Aminoglycosides Signup and view all the answers

Which category of antibiotics can generally penetrate the CSF when the meninges are inflamed and used in high doses?

β-lactam antibiotics Signup and view all the answers

What is the major indication for Ampicillin and Amoxicillin in the treatment of bacterial meningitis?

Treatment of L. monocytogenes Signup and view all the answers

Why is vancomycin indicated in the treatment of bacterial meningitis?

Allergic reaction to Penicillins Signup and view all the answers

Which antibiotic is recommended as the first-line empiric therapy in the treatment of bacterial meningitis?

Cefotaxime or ceftriaxone Signup and view all the answers

What is the main reason behind the recommendation to avoid using tetracyclines in the treatment of bacterial meningitis?

Poor penetration through lipid barriers Signup and view all the answers

What is the mode of action (MOA) of chloramphenicol in the treatment of bacterial meningitis?

Protein synthesis inhibitor (50S ribosomal subunit) Signup and view all the answers

Why should aminoglycosides be combined with b-lactams or glycopeptides in the treatment of bacterial meningitis?

To increase bactericidal activity Signup and view all the answers

Which antibiotic has broad spectrum activity against Gram-positive and Gram-negative bacteria, anaerobes, and atypical organisms, and is well transmitted via blood to CSF?

Moxifloxacin Signup and view all the answers

What is the main reason behind recommending vancomycin to be combined with b-lactams in the treatment of bacterial meningitis?

To increase bactericidal activity Signup and view all the answers

Why is moxifloxacin considered as the drug of choice in the treatment of bacterial meningitis?

50 Signup and view all the answers

What is the mode of action (MOA) of Carbapenems in the treatment of bacterial meningitis?

Cell wall synthesis inhibitor Signup and view all the answers

Study Notes

Antibiotic Penetration in Meningitis

Beta-lactam antibiotics generally penetrate the CSF only when the meninges are inflamed.

Empiric Antibiotic Treatment in Acute Bacterial Meningitis

The most important consideration for the choice of empiric antibiotic treatment in acute bacterial meningitis is the patient's age.

Antibiotics and CSF Penetration

Chloramphenicol can penetrate the CSF even when the meninges are not inflamed.
Aminoglycosides generally penetrate the CSF poorly under all circumstances.
Beta-lactam antibiotics can generally penetrate the CSF when the meninges are inflamed and used in high doses.

Primary Action Required in Acute Bacterial Meningitis

The primary action required for acute bacterial meningitis is rapid initiation of empiric antibiotic treatment.

Indications for Antibiotics in Bacterial Meningitis

Ampicillin and Amoxicillin are indicated for Listeria monocytogenes infections.
Vancomycin is indicated due to the increased prevalence of pneumococcal resistance to beta-lactam antibiotics.
Cefotaxime or Ceftriaxone are recommended as the first-line empiric therapy in the treatment of bacterial meningitis.

Contraindications and Precautions

Tetracyclines are not recommended in the treatment of bacterial meningitis due to the risk of increased intracranial pressure.
Aminoglycosides should be combined with beta-lactams or glycopeptides in the treatment of bacterial meningitis to reduce the risk of toxicity.
Meropenem has broad spectrum activity against Gram-positive and Gram-negative bacteria, anaerobes, and atypical organisms, and is well transmitted via blood to CSF.

Mode of Action and Combination Therapy

Chloramphenicol inhibits protein synthesis by binding to the 50S ribosomal subunit.
Vancomycin should be combined with beta-lactams in the treatment of bacterial meningitis to provide synergistic activity against Streptococcus pneumoniae.
Moxifloxacin is not considered the drug of choice in the treatment of bacterial meningitis due to concerns about resistance and CNS toxicity.
Carbapenems inhibit bacterial cell wall formation by binding to the penicillin-binding protein.

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Description

Test your knowledge of the drug treatment for acute bacterial meningitis. Learn about the urgent administration of antibiotics and the choice of empiric antibiotic treatment based on patient age and regional factors.