Tag Archives: Vancomycin

Bacterial Meningitis: Antimicrobial Therapy

The initial management of the patient with suspected acute bacterial meningitis is empiric antimicrobial and adjunctive therapy begun immediately after obtaining blood for bacterial culture. Respiratory isolation for the first 24 hours of antimicrobial therapy is recommended only for patients with suspected meningococcal meningitis. Respiratory isolation is not required for patients with meningitis due to… Read More »

Delirium: Etiology

Delirium has a wide variety of etiologies, which may occur alone or in combination (). These include primary cerebral disorders, systemic disturbances that affect cerebral function, drug and toxin exposure (including intoxication and withdrawal), and a range of factors that can contribute to delirium but have an uncertain role as etiological factors by themselves (psychological… Read More »

Principles of Antimicrobial Therapy

A governing principle in the treatment of infectious diseases is summarized by the aphorism “the right drug for the right bug,” a statement that is as complex as it is simple. This aphorism is particularly critical when considering infections involving the central nervous system (CNS) for two main reasons: (1) the blood-brain barrier (BBB) limits… Read More »

Pharmacodynamics Of Antimicrobial Agents In Bacterial Meningitis

Pharmacodynamics entails the interactions that occur between the antimicrobial agent and the pathogen, and, although separate from pharmacokinetic properties, is dependent on these processes with respect to localizing antimicrobials at sites of infection. There are several pharmacodynamic properties of antimicrobials relevant to bacterial meningitis, including bactericidal / bacteriostatic activity, time- versus concentration-dependent killing, and postantimicrobial… Read More »

Corticosteroid Effects On Antimicrobial CSF And Bacterial Killing

Bacterial growth and death in the cerebrospinal fluid (CSF) both result in the release of proinflammatory bacterial products, such as peptidoglycan or lipopolysaccharide (LPS) that worsen central nervous system inflammation. For example, lipopolysaccharide activates Toll-like receptor 4 signaling in a wide variety of cells, ultimately leading to nuclear factor kappa B (NF-kB)-mediated transcription of proinflammatory… Read More »

Empiric Antimicrobial Therapy For Bacterial Brain Abscess

As stated above, the bacteria found in brain abscesses correspond to predisposing conditions such as pathogenesis of infection, host immunity, or events leading to direct inoculation. These predisposing conditions must be considered when designing an empiric antimicrobial regimen for patients with brain abscesses. Table Empiric antimicrobial therapy for brain abscess delineates a number of predisposing… Read More »