MANAGEMENT OF NON-ADULT ACUTE BACTERIAL MENINGITE

Abstract

Introduction: Meningitis involves the brain and spinal cord, corresponding to an inflammation of the leptomeninges. Acute bacterial meningitis (MBA) is a neurological emergency, as it has high morbidity and mortality. The identification of the disease as early as possible and the initiation of the respective treatment is important to improve the patient's prognosis. Objective: To analyze the management of patients with acute bacterial meningitis. Methodology: This is an integrative review of the last 5 years, from 2020 to 2025, the site used for research was the Virtual Health Library (VHL). The databases used were the Latin American and Caribbean Literature on Health Sciences (LILACS), IBECS and Medline. The descriptors used were: "treatment" "meningitis" "bacterial" "management". A total of 52 articles were found, which were submitted to the selection criteria. In addition, a document from the Neurology Treaty of the Brazilian Academy of Neurology was used. The inclusion criteria were articles that were made available in full and that were related to the proposal studied. The exclusion criteria were articles available in the form of abstracts, case reports and those that were not related to the proposal studied. Results and Discussion: The use of antibiotic therapy is important for the treatment of this disease. It is used empirically in clinical suspicion, as its postponement is associated with increased mortality. The most commonly used class of antibiotics are beta-lactams, among them, mainly, penicillin G, ampicillin, cefepime, meropenem, ceftriaxone and cefotaxime. In newborns it is done with cefotaxime associated with ampicillin. In children and adults, a 3-generation cephalosporin, such as ceftriaxone or cefotaxime, is used along with vancomycin. Patients over 50 years of age use a 3rd generation cephalosporin, plus vancomycin and ampicillin. Immunosuppressed patients use vancomycin, ampicillin, and cefepime or meropenem. The use of corticosteroids is important to reduce the inflammatory response and improve the prognosis. Prophylactic antibiotics may be used in some cases. The use of the vaccine helps prevent the disease. Conclusion: From this perspective, the importance of appropriate management is evidenced, through diagnostic suspicion and early treatment to reduce morbidity and mortality, thus improving the patient's prognosis.