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Bacterial meningitis in the neonate: Treatment and outcome

Morven S Edwards, MD
Carol J Baker, MD
Section Editors
Sheldon L Kaplan, MD
Leonard E Weisman, MD
Deputy Editor
Carrie Armsby, MD, MPH


Bacterial meningitis is more common in the first month than at any other time of life [1]. Despite advances in infant intensive care, neonatal meningitis remains a devastating disease.

The mortality rate has declined from almost 50 percent in the 1970s to contemporary rates of less than 10 percent [2-5]. However, morbidity from neonatal meningitis is relatively unchanged [6]. Survivors remain at high risk for neurologic sequelae and lifelong impairment as a result of infectious insult to their developing brains [3,5].

The treatment and outcome of bacterial meningitis in the neonate (age <1 month) will be discussed here. The clinical features, diagnosis, and complications are discussed separately, as is bacterial meningitis in older children. (See "Bacterial meningitis in the neonate: Clinical features and diagnosis" and "Bacterial meningitis in the neonate: Neurologic complications" and "Bacterial meningitis in children older than one month: Clinical features and diagnosis" and "Bacterial meningitis in children older than one month: Treatment and prognosis" and "Bacterial meningitis in children: Neurologic complications".)


Initial care for all neonates with meningitis should be provided in an intensive care setting. Although there are no data to quantify the impact of supportive care measures, adequate oxygenation, prevention of hypoglycemia, effective anticonvulsant therapy, control of intracranial hypertension, and prevention of fluctuations in cerebral blood flow are considered crucial parts of the management of neonates with bacterial meningitis [7].

Supportive measures for neonates with meningitis may include:

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Literature review current through: Oct 2017. | This topic last updated: Jul 27, 2017.
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