Zusammenfassung
Die eitrige Meningitis ist eine akute, zumeist durch Bakterien verursachte Erkrankung.
Seit mehr als 50 Jahren hat die Verfügbarkeit wirkungsvoller antibiotischer Chemotherapeutika
nichts daran geändert, dass die Erkrankung noch immer bei mehr als 20 % der Erkrankten
im Erwachsenenalter tödlich verläuft. Die Überlebenden leiden häufig an neurologischen
oder neuropsychologischen Residualsymptomen. Im Folgenden beziehen wir uns vor allem
auf die außerhalb des Krankenhauses erworbene bakterielle Meningitis des Erwachsenen.
In Deutschland empfehlen wir für die kalkulierte antibiotische Therapie eine Behandlung
mit Ampicillin und einem Drittgenerations-Zephalosporin. Eine Reduktion der Sterblichkeit
und der neurologischen Spätschäden durch die Gabe von Dexamethason konnte kürzlich
in einer Studie an Erwachsenen demonstriert werden.
Abstract
Usually, purulent meningitis is an acute bacterial disease. For more than fifty years,
antibiotic chemotherapy is widely available. However, the course of bacterial meningitis
remains lethal in more than 20 % of affected adult patients. Survivors often suffer
from neurological and neuropsychological sequelae. The following article provides
an overview of the current therapeutical concepts for community acquired bacterial
meningitis in adults. For the treatment of purulent meningitis in Germany, we recommend
ampicillin and a third-generation cephalosporin as initial antibiotic therapy. A recent
study demonstrated a reduction of mortality and neurological sequelae with adjuvant
dexamethasone therapy.
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Dr. Holger Schmidt
Universität Göttingen · Abteilung Neurologie
Robert-Koch-Straße 40
37075 Göttingen
Email: hschmid2@gwdg.de
