Before the development of antibiotics, most people with bacterial meningitis died. “But now with prompt antibiotic treatment, the vast majority of patients with bacterial meningitis survive,” says Lise Nigrovic, MD, attending physician in pediatric emergency medicine at Children’s Hospital, Boston, and instructor of pediatrics at Harvard Medical School.
What Are Antibiotics?
Antibiotics are medicines that fight infections caused by bacteria. They work by seeking out and killing the harmful bacteria. According to the National Institutes of Health, appropriate antibiotics for meningitis treatment can reduce the risk of dying from bacterial meningitis to below 15 percent.
Antibiotics can also reduce the risk of serious complications and brain damage in bacterial meningitis patients. However, it’s important that antibiotics be started early. “Ideally, antibiotic treatment should begin within hours of the onset of severe symptoms,” says Dr. Nigrovic.
How Are Antibiotics Given to a Patient With Meningitis?
Because bacterial meningitis can be life-threatening, standard meningitis treatment involves delivering the antibiotics intravenously, through a vein, in the hospital.
“IV [intravenous] antibiotics will ensure that high levels of the medicine will get into the central nervous system where the infection really exists,” says Nigrovic.
Oral antibiotics are less reliable for meningitis because their infection-fighting ability can be hampered by vomiting, poor absorption in the gastrointestinal tract, and other uncertainties. Antibiotics are typically given three times a day for 7 to 21 days, depending on the type of bacteria organism causing the meningitis and the type of antibiotic chosen. Patients are often in an intensive care unit of a hospital during meningitis treatment so that they can be watched carefully to be sure the antibiotic treatment is effective.
Which Antibiotics Are Most Helpful for Meningitis Treatment?
The antibiotics or combination of antibiotics that will be most helpful depend on the type of bacteria causing the meningitis infection. Often this can be determined by analyzing a sample of fluid obtained with a test called a lumbar puncture, or spinal tap. Because the results of this test may take several hours, broad-spectrum antibiotics — effective against a range of bacteria — are often given in the meantime.
After results of spinal fluid tests become available, different antibiotics may be delivered alone, or in combination, as indicated.
Commonly used meningitis treatments include a class of antibiotics called cephalosporins, especially Claforan (cefotaxime) and Rocephin (ceftriaxone). Various penicillin-type antibiotics, aminoglycoside drugs such as gentamicin, and others, are also used.
Some forms of bacterial meningitis are particularly dangerous as well as very contagious, so family members and friends who’ve had contact with the patient may need to take prophylactic antibiotics to prevent getting the disease.Cipro (ciprofloxacin) is most commonly used for preventive meningitis treatment.
The Growing Problem of Antibiotic Resistance
Antibiotic resistance is becoming a threat to effective meningitis treatment because some of the antibiotics traditionally used are no longer effective.
Antibiotic resistance is the ability of some bacteria to adapt over time and fend off the effects of drugs meant to kill or weaken them. This can happen when bacteria are repeatedly exposed to the same antibiotic or when antibiotics are used inappropriately.
“One type of bacterial meningitis has now become resistant to an antibiotic we’ve used for years, which is penicillin,” says Nigrovic.
Fortunately, other antibiotics are still effective treatments for meningitis. “Vancomycin works against many bacteria that are not killed by other antibiotics,” says Vigrovic. And an older oral drug, Rifadin (rifampin), as well as the less convenient, injectable-only, Rocephin (ceftriaxone) can be used as prophylactic treatment for those exposed to someone with meningitis.
Take antibiotics only when they’re prescribed by your doctor, and always finish the entire course of antibiotics instead of saving some for the next time you’re sick. Why? Because if you skip even one or two pills, the remaining bacteria could resist future antibiotic treatment.
Also, ask your doctor if you have all the vaccinations you need to protect yourself from meningitis and other illnesses. Vaccines are available to prevent some types of bacterial meningitis. If you stay healthy, there will be no need to take antibiotics. And that’s the best prescription of all when it comes to effective meningitis treatment.