Advertisement

Syndicate

Physician Resources Home arrow Medical News arrow Clinical Guidelines Identify Children at Risk of Bacterial Meningitis
Clinical Guidelines Identify Children at Risk of Bacterial Meningitis
Written by Jeanne Bohm, Ph.D.   

A set of new guidelines can help predict the risk of bacterial meningitis for children with cerebrospinal fluid pleocytosis, reducing unnecessary hospitalizations and antibiotics, according to a study in the January 3 issue of JAMA

Discuss this article on the forums. (0 posts)

The majority of children with cerebrospinal fluid (CSF) pleocytosis have viral rather than bacterial meningitis. However, because exclusion of bacterial meningitis requires negative CSF (and blood) cultures, 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 children with a near-zero risk of bacterial meningitis could assist 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 a clinical prediction rule, the Bacterial Meningitis Score, which classifies patients at very low risk of bacterial meningitis if they lack 5 criteria. The multicenter study was conducted 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). The sensitivity of the Bacterial Meningitis Score for bacterial meningitis was 98.3 percent and the specificity was 61.5 percent.

The authors recommend admission to the hospital and administration of parenteral antibiotics for patients with at least 1 Bacterial Meningitis Score risk factor or who are younger than 2 months.

Conclusions of the study include that bacterial meningitis has become an uncommon disease in U.S. children. Use of the Bacterial Meningitis Score prediction rule could reduce unnecessary hospital admissions for children with CSF pleocytosis with very low risk of bacterial meningitis.

Sources:

JAMA Media Release

Clinical Prediction Rule for Identifying Children With Cerebrospinal Fluid Pleocytosis at Very Low Risk of Bacterial Meningitis: JAMA. 2007;297:52-60.

About the Author

Jeanne Bohm, Ph.D. is a cancer biologist by training, a medical writer and an experienced science educator.

The author has no financial relationship to any of the companies listed in the article.

From the NetDoc medical news feed

Discuss this article on the forums. (0 posts)

 
< Prev   Next >

Common Diseases

Swine Flu - Updates and information on H1N1 2009 (AKA Swine Influenza) pandemic.

Ankylosing spondylitis - Current protocols for diagnosis and treatment options.

Wegener granulomatosis - Autoimmune etiology and clinical course.

Diabetes - disease and management information, including diagnosis, typical treatment plans and diabetes supplies.

Advertisement

Medical Careers

The US medical jobs market has stayed hot for health care providers. Whether you believe that a provider shortage is in the offing or that the ratio of physicians-to-patients is too high, physician jobs and nursing jobs abound.

A wide variety of medical jobs can be found in the netdoc health care job listings. Particular strengths include permanent and locum tenens physician jobs, nursing jobs across the US, and radiology positions.

Other resources include physician salary information, medical career guidance, and the ability to post physician jobs.

Polls

When hiring your medical practice office manager, what was the most important consideration?
 
Copyright 2005 - 2019 Medical Resource Group, LLC. All rights reserved.